Your Medicare Coverage

Is my test, item, or service covered?

Prosthetic devices

How often is it covered?

Medicare Part B (Medical Insurance) covers prosthetic devices needed to replace a body part or function. A doctor or other health care provider enrolled in Medicare must order the prosthetic device.

Prosthetic devices include:

Who's eligible?

All people with Part B 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. It doesn't matter who submits the claim (you or your supplier).

Note

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

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