Does Medicare Cover Knee Braces?

Jory Cross by Jory Cross | Licensed since 2012
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This article was updated on: 09/10/2018

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Patients with osteoarthritis may need to wear a knee brace. Osteoarthritis is caused by wear and tear inside the knee joints, according to the U.S. National Library of Medicine. A knee brace shifts weight off the most damaged part of the knee, reports the Mayo Clinic. Before you are prescribed a knee brace, you may experience the bones in your knee joint rubbing together, causing pain, swelling, and stiffness. With a knee brace you may be able to walk longer distances more comfortably. Some people wear their knee braces only while walking or exercising and some people wear their knee brace most of the day. A knee brace may help delay knee replacement surgery, according to the U.S. National Library of Medicine.

Does Medicare cover knee braces?

Medicare Part B covers knee braces when medically necessary as it is considered to be durable medical equipment. Durable medical equipment can withstand repeated use and has an expected lifetime of at least three years. To be covered, the knee brace must first be deemed medically necessary and ordered by your health-care provider. Your Medicare Part B cost sharing for a Medicare-approved knee brace is generally 20% of the Medicare-approved amount, after you reach the Part B deductible. Without insurance, a custom-made knee brace can cost more than $1,500 according to the Mayo Clinic.

What type of knee brace can I get?

To get Medicare coverage the type of knee brace has to qualify — it should be a rigid or semi-rigid device used to support a weak or deformed body part or to restrict motion in a damaged body part. Knee braces come in a variety of designs, according to the Mayo Clinic. They are usually made of metal or plastic to provide structure and support combined with rubber or foam for padding and positioning. The purpose of a knee brace is to take pressure off the part of the joint most damaged by osteoarthritis therefore relieving pain.

Your doctor may refer you to orthotist, a health professional who builds and fits knee braces and other types of braces to help people with orthopedic (musculoskeletal) problems. You may be able to take home an off-the-shelf knee brace that fits or you may get a custom knee brace designed to your exact measurements.

Do you want more information about Medicare coverage of knee braces?

Did you know you can get a private Medicare plan that provides your Medicare Part A and Part B benefits while offering you additional coverage? A Medicare Advantage plan for example, must cover all the services that Original Medicare covers, but often at a lower cost to you. I can tell you more. You can schedule a one-on-one phone call or get an email from me with plan information. If you want to compare some plans now, click the Compare Plans buttons on this page.

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