Does Medicare Cover Orthotics?

Medicare does cover orthotics that a doctor has deemed medically necessary, and as long as the doctor and orthotic supplier are enrolled in and participate in Medicare. Medicare Part B will typically cover 80% of the Medicare-approved amount.

If you have foot or back pain, a spinal injury, osteoarthritis or other orthopedic condition, your doctor may prescribe an orthotic device as a part of treatment. Learn more below.

Orthotics is a medical specialty concerned with the making and fitting of medical devices designed to support, align, relieve or correct orthopedic problems. These supportive orthotic devices are most commonly used to:

• Facilitate healing following an injury or surgical procedure
• Reduce pain by restricting mobility
• Support weak or deformed joints and muscles

Are Orthotics Covered by Medicare?

Yes. There are a wide variety of orthotics (prefabricated and custom-made) prescribed to patients that Medicare covers under the durable medical equipment (DME) benefit. Medicare orthotics can include:

• Ankle, foot and knee bracing
• Back, neck and spinal bracing
• Hand, wrist and elbow bracing
• Orthopedic shoes when they're a necessary part of a leg brace
• Prosthetic devices such as artificial limbs and eyes

How to get orthotics covered by insurance like Medicare:

• Your doctor or physician must determine that the orthotics are medically necessary and prescribe it as part of your treatment plan.
• The DME suppliers you use must be enrolled in and participate in Medicare.

What Medicare Will Pay

Generally, if you meet all of the requirements for getting coverage, Medicare Part B will cover 80% of the Medicare-approved amount for orthotics, and then you typically pay the 20% Medicare Part B coinsurance out-of-pocket (after your annual Part B deductible is met).