Quick Answer
Original Medicare will cover a variety of prosthetics to replace a body part or function when medically necessary. When you think of prosthetics, arms and legs may be the first things that come to mind. However, prosthetic devices range from things like artificial teeth, eyes, and facial bones, to a
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Original Medicare | Not Covered | Does not cover this service directly |
| Medicare Advantage | Not Covered | Check plan's Evidence of Coverage |
| Medigap | Not Covered | Only supplements Original Medicare benefits |
| Medicare Part D | May Cover Related Rx | May cover related prescriptions |
Understanding Your Coverage Options
Original Medicare (Part a & B)
Original Medicare is made up of Medicare Part A and Part B. Each part of Medicare provides different coverage and requires you to pay a different coinsurance amount depending on your care. Here’s how Medicare covers prosthetics:
Since each situation is unique to the beneficiary, it’s important to talk with your doctor to see how Medicare will cover your prosthetics. It’s also worth noting that in order to use your Medicare coverage, you must be receiving healthcare from a Medicare-approved doctor or facility.
The Medicare guidelines for orthotics and prosthetics are straightforward. Still, we’ll continue to break down some of the most common prosthetic devices covered by Medicare for a clearer idea of how your coverage will work.
Medicare Advantage (Part C)
Since each situation is unique to the beneficiary, it’s important to talk with your doctor to see how Medicare will cover your prosthetics. It’s also worth noting that in order to use your Medicare coverage, you must be receiving healthcare from a Medicare-approved doctor or facility.
The Medicare guidelines for orthotics and prosthetics are straightforward. Still, we’ll continue to break down some of the most common prosthetic devices covered by Medicare for a clearer idea of how your coverage will work.
Medicare Supplement (Medigap)
Since each situation is unique to the beneficiary, it’s important to talk with your doctor to see how Medicare will cover your prosthetics. It’s also worth noting that in order to use your Medicare coverage, you must be receiving healthcare from a Medicare-approved doctor or facility.
The Medicare guidelines for orthotics and prosthetics are straightforward. Still, we’ll continue to break down some of the most common prosthetic devices covered by Medicare for a clearer idea of how your coverage will work.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is a licensed Medicare expert who has been helping beneficiaries navigate their Medicare options for over a decade.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent dedicated to helping those eligible for Medicare find the best coverage options.