Prosthetic devices
Medicare Coverage Information
Overview
Medicare provides coverage for medically necessary prosthetic devices that help restore function or replace a body part. Coverage is typically available through Medicare Part B for beneficiaries who have a documented medical need for prosthetics.
- Prosthetic devices must be prescribed by a Medicare-approved physician
- Covers artificial limbs, eyes, and other medically necessary body parts
- Requires documentation proving medical necessity
- Covered under Medicare Part B as durable medical equipment
- Partial coverage with beneficiary responsible for 20% of approved costs
- Medicare Part B beneficiaries
- Individuals with a medical condition requiring prosthetic devices
- Must have a prescription from a qualified healthcare provider
- Beneficiaries typically pay 20% of the Medicare-approved amount after meeting the Part B deductible
- Medicare covers 80% of the approved cost for prosthetic devices
- Additional costs may apply for advanced or specialized prosthetics
- Prosthetics must be deemed medically necessary by a healthcare provider
- Cosmetic prosthetics are generally not covered
- Replacement or repair of prosthetics may have specific restrictions
- Must be prescribed and fitted by a Medicare-approved provider
- Consult with your doctor about medical necessity of prosthetic devices
- Get a detailed prescription and documentation
- Contact Medicare or your Medicare Advantage plan for specific coverage details
- Verify provider is Medicare-approved before proceeding
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare prosthetic devicesprosthetics coverageMedicare Part B prostheticsartificial limbsmedical equipment
Related Coverage Topics
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