Your Medicare Coverage
Is my test, item, or service covered?
How often is it covered?
Medicare Part B (Medical Insurance) covers prosthetic devices needed to replace a body part or function when ordered by a doctor or other health care provider enrolled in Medicare.
Prosthetic devices include:
- Medicare-approved corrective lenses needed after a cataract operation (eyeglasses/contact lenses)
- Ostomy bags and certain related supplies
- Breast prostheses (including a surgical bra) after a mastectomy
- Surgically implanted prosthetic devices in a hospital inpatient setting (Part A) and in a hospital outpatient setting (Part B)
All people with Medicare are covered.
Your costs in Original Medicare
You must go to a supplier that's enrolled in Medicare for Medicare to pay for your device. You pay 20% of the Medicare-approved amount for external prosthetic devices, and the Part B deductible applies. Medicare will only pay for prosthetic items furnished by a supplier enrolled in Medicare, no matter who submits the claim (you or your supplier).
To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.