Prosthetic devices
Medicare Part B (Medical Insurance) covers prosthetic devices when a doctor or other health care provider orders them
Description
Prosthetic devices replace a body part or function. Examples of prosthetic devices include:
- Breast prostheses (including a surgical bra).
- One pair of conventional eyeglasses or contact lenses provided after a covered cataract surgery.
- Ostomy bags and certain related supplies.
- Some surgically implanted prosthetic devices, including cochlear implants.
- Urological supplies.
Coverage details
Either Part A or Part B covers a surgically implanted prosthetic device depending on if the surgery takes place in an inpatient or outpatient setting.
Provider requirements
For Medicare to pay for your prosthetic device, you must get it from a Medicare-enrolled supplier. This is true no matter who submits the claim (you or the provider).
Costs
After you meet the Part B deductible , you pay 20% of the Medicare-approved amount .
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service