covers prosthetic devices needed to replace a body part or function when a doctor or other health care provider enrolled in Medicare orders them.
Prosthetic devices include:
You pay 20% of the
for external prosthetic devices, and the Part B
applies. Medicare will only pay for prosthetic items furnished by a supplier enrolled in Medicare. It doesn't matter who submits the claim (you or your supplier).
To find out how much your test, item, or service will cost, talk to your doctor or 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
- Where you get your test, item, or service
You must go to a supplier that’s enrolled in Medicare for Medicare to pay for your device. Part A or Part B covers surgically implanted prosthetic devices depending on whether the surgery takes place in an inpatient or outpatient setting.
Medicare will only pay for prosthetic items furnished by a supplier enrolled in Medicare, no matter who submits the claim (you or your supplier).