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. A doctor or other health care provider enrolled in Medicare must order the prosthetic device.
Prosthetic devices include:
- One pair of conventional eyeglasses or contact lenses provided after a cataract operation
- Ostomy bags and certain related supplies
- Urological supplies
- Breast prostheses (including a surgical bra) after a mastectomy
- Cochlear implants and certain other surgically implanted prosthetic devices
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).
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