Medicare Blog

what are the medicare allowables on back and knee braces?

by Chanelle Hoeger Published 2 years ago Updated 2 years ago

Are back braces covered by Medicare?

As a general rule, Medicare back braces are covered as long as the individual needs the brace for a medical reason. A medically necessary brace is covered under Medicare Part B. You may need to pay a stated co-pay, which is usually 20 percent, and your deductible on Medicare Part B applies to the cost of the brace.

Is a knee brace covered by Medicare?

Knee braces are covered under Part B of Medicare, which means that 80 percent of your costs for the durable medical equipment will be covered. You will have to pay the remaining 20 percent once your deductible—$183 for Part B as of 2018—is fully paid for the year.

Is a brace considered durable medical equipment?

In simple terms, DME is medical equipment that is used for specific treatment of a medical condition, illness, or injury. The equipment should be reusable and considered nondisposable. 1 Examples of DME include braces or orthosis, wheelchairs, walkers, canes, hospital beds, and similar supplies.

Does Medicare pay for AFO braces?

Ankle-foot orthoses (AFO) and knee-ankle foot orthoses (KAFO) are covered under the Medicare Braces Benefit.

Does Medicare pay for orthopedic braces?

Orthotics are devices used to treat injured muscles and joints. Medicare will typically cover 80 percent of the costs for orthotic devices under Medicare Part B if they are deemed medically necessary by a doctor. You are still responsible for 20 percent of the cost after you meet your deductible.

How much does a knee brace cost?

A knee brace to provide relief from arthritis can cost from $50-$900, depending on the severity and the support needs. BraceShop.com charges about $50 to almost $900 for a knee brace for arthritis.

Is a knee brace an orthopedic device?

An orthopedic brace can be a very useful medical device when nursing or preventing an injury. The purpose of an orthopedic brace is to comfortably limit the movement of the patient's body part, (ie. knee, lower back, wrist, elbow, ankle, etc) and to protect it from getting aggravated.

Who can prescribe a back brace?

A spinal brace may be prescribed by your doctor to help stabilize one or more levels of your spine, stop or control spinal movement, lift pressure off an area of the spine, help prevent re-injury while you heal, and relieve pain.

Are braces covered by Medicaid?

The answer is yes! If braces are deemed medically necessary for your child, Medicaid can assist in getting them.

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