Braces (arm, leg, back, & neck)
Medicare Coverage Information
Overview
Medicare Part B covers medically necessary braces for arms, legs, back, and neck when prescribed by a healthcare provider. These braces are considered durable medical equipment (DME) and must be deemed essential for treating a medical condition.
- Braces must be prescribed by a Medicare-enrolled physician
- Covered under Medicare Part B as durable medical equipment
- Requires documentation proving medical necessity
- Braces must be used to treat a specific medical condition
- Supplier must be Medicare-approved
- Medicare Part B beneficiaries
- Individuals with a documented medical need for braces
- Patients with a prescription from a Medicare-enrolled physician
- Beneficiary typically pays 20% of Medicare-approved amount after meeting Part B deductible
- Medicare covers 80% of the approved cost for medically necessary braces
- Actual out-of-pocket costs may vary by specific Medicare plan
- Braces must be deemed medically necessary by a healthcare provider
- Cosmetic braces are not covered
- Requires prior authorization from Medicare
- Must be prescribed as part of a treatment plan
- Consult with your healthcare provider about medical necessity
- Get a detailed prescription specifying the required brace
- Verify the brace supplier is Medicare-approved
- Check with your Medicare plan about specific coverage details
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare bracesmedical braces coverageMedicare durable medical equipmentorthopedic bracesMedicare Part B
Related Coverage Topics
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