Does Medicare Cover Orthotics?
This article was updated on: 10/21/2018
Your doctor may prescribe orthotic devices, or braces, to support weak joints or muscles. If you have foot pain or other health conditions involving your feet, your podiatrist or other provider might prescribe custom orthotics for your feet. Medicare Part B may cover orthotics in some situations.
Original Medicare coverage for various types of orthotics
People often think of orthotics as custom-made shoe inserts that can relieve foot pain. That’s a popular type of orthotic, but there are other types as well, such as back braces. Medicare counts them as durable medical equipment. Medicare Part B may cover orthotics if both of the following are true:
- Your Medicare doctor (or podiatrist) prescribes orthotics for you as medically necessary.
- You buy the orthotics from a Medicare-participating supplier.
Medicare Part B may also cover therapeutic shoes and inserts for people with diabetes who suffer from severe diabetic foot disease, if your Medicare-assigned doctor certifies that you need them. As with orthotics, these items must come from a Medicare-participating supplier.
Medicare classifies orthotics under the “Durable Medical Equipment Prosthetics, Orthotics, & Supplies (DMEPOS)” category. If you meet the conditions described above, Original Medicare generally pays 80 percent of the Medicare-approved cost for orthotics, therapeutic shoes, and shoe inserts after you have met your deductible; after that, you’ll only be responsible for the remaining 20 percent. You might want to take a look at this article on planning your Medicare health costs for retirement.
Medicare Advantage coverage for various types of orthotics
Did you know you can get your Medicare Part B (and Part A) benefits through a type of Medicare plan that’s available through private, Medicare-approved insurance companies? The program is called Medicare Advantage, or Medicare Part C, and it’s another way to get your Medicare coverage. Many Medicare Advantage plans even include prescription drug coverage (called a Medicare Advantage Prescription Drug plan or MAPD) — that’s something for which Original Medicare, Part A and Part B, offers only limited coverage, typically not extending to the prescription medications you take at home. There may be a choice of Medicare Advantage plans available in your area. You need to continue paying your Part B premium when you have a Medicare Advantage plan, along with any premium the plan may charge.
I’d be happy to explain the different types of Medicare plans. You can take a look at my profile, if you’d like — simply click on the “View profile” link below. If you prefer, you can arrange a phone call with me at your convenience, or I can send you information about your Medicare plan options by email; just use the links below. A lot of people like to check out Medicare plan options on their own by clicking the Find Plans button on this page.
This website and its contents are for informational purposes only. Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.