Medicare Coverage of Medical Braces


What It Is

Brace for the neck, back, or a limb

What's Covered

Medicare Part B can cover a brace for the neck, back, or a limb if prescribed by a physician or other appropriate healthcare provider. The brace must be provided by a Medicare-certified medical equipment supplier or other Medicare-certified provider.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for medical braces, contact the plan directly.

What Medicare Pays

Medicare Part B pays 80 percent of either purchase or rental, depending on the type of brace.

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

  • The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care must be performed or delivered by a healthcare provider who participates in Medicare.

Was this medicareinformation helpful?

Add Your Comment. Add Your Wisdom.

Default_avatar-hhd399496100

Want More Medicare Info?

< Browse Other Medicare Topics
Stay Connected With Caring.com

Receive the latest news and tips in your inbox

Join our social communities: