Does Medicare Cover Knee Braces

Knee braces are vital equipment to help seniors or adults that suffer from joint issues like arthritis or who have suffered an injury and need extra support by using a knee brace.   I remember when a family member had knee surgery and during the healing process was instructed to use a knee brace to help in the recovery efforts to make the process more comfortable. 

So does Medicare cover knee braces?  Yes, knee braces are covered by Medicare under part B when they are medically necessary and are considered to be durable medical equipment.  Because the knee brace needs to be deemed medically necessary and cleared and ordered by your current health care provider.  Generally, you can expect cost-sharing from your Medicare Part B to be about 20 percent after you reach the part B deductible approved amount.

For those of you who need a knee brace and qualify because of Medicare and have been cleared by your doctor it is important to try and get Medicare involved and approved because without insurance a custom knee brace is not cheap. 

You can expect to pay upwards of 1,000 dollars or more on your own for a custom knee brace.  There are other types of knee braces that we explain more about below but they typically do not get covered by Medicare and you can purchase them independently from Medicare. 

Table of Contents

What is a knee brace?

A knee brace is considered a tool to help manage knee discomfort because of osteoarthritis, post-op patients from knee surgery, or other knee injuries to help sift weight off the damaged part of the knee. 

When wearing a proper knee brace can help you walk easier and farther with less pain and discomfort.  Knee braces are typically made from either a plastic or metal structure and supported with whether foam or rubber for padding.

There may be times that your doctor even has you use a cane, walker, or even a wheelchair to help promote healing while wearing a knee brace. 

What types of knee brace can you get with Medicare coverage?

There are a lot of different types of knee brace but to get it covered by Medicare it should be either a semi-rigid or rigid knee brace that is used to help support the week knee and restrict the motion to help with pain and healing. 

Styles of knee braces

The most important part of a knee brace is making sure it fits correctly Below are the main style of knee braces and they are”

  • Wraparound Braces:  These types of braces are put on by wrapping them around your knee to help with stabilizing the knee and relieving pressure.  They are good for moderate to mild types of pain.
  • Hinged Knee Braces:  These are the types of braces that Medicare will cover.  Rigid and semi-rigid styles allow for excellent support of the knee that needs the brace.  Rigid knee braces as the name suggest are the firmest or stiffest of braces that offer anywhere from moderate to complete support.  For those that need a little more flexibility, a semi-rigid brace will allow for that.
  • Knee Sleeves:  These types of braces are mostly found in sleeves and either has a closed or open patella design.  They are designed to take pressure off of the knee.  These are typically not covered by Medicare and in fact, mostly hinged knee braces are what gets covered by Medicare. 

How much might i have to pay for a knee brace?

Knee brace for pain

Like we mentioned above knee braces especially custom, rigid, and semi-rigid braces are not cheap.  Pricing can vary widely and depend on the brace can be under 100.00 to over 1500 for a custom-made and fit knee brace.

Knee braces that are covered by Medicare Part B meaning that Medicare will cover 80 percent of the cost of the brace.  And you will have to pay for the remaining 20 percent.  Once your deductible is met for Part B.  If you have a Medicare Advantage plan that you could be in luck and have it paid in full without any money out of pocket on yoruend. 

Because of the expensive of a custom knee brace or if you need a ridged or semi-ridged brace it is best to consult with your doctor and get the proper recommendations that can be covered by Medicare.  This can help you save a lot of money and provide you with a quality brace that is best for you. 

Did you know that the largest cause of problems in the knee in seniors is osteoarthritis? There is about 30 percent of seniors currently suffer from this condition.

Final thoughts on Medicare paying for knee braces

As you can see knee braces are essential for some to walk more comfortable while taking pressure off the knee and promote healing.  There are different knee braces with wide price ranges depending on what type of knee brace you get. 

For those that have Medicare and qualify for a knee brace, you can expect to have 80 percent paid for the cost of the brace.  Those who are on Medicare Advantage plans might have the entire cost covered.  For those on Medicare be sure to check with your doctor to see if you qualify. 

Related articles to Medicare

0/5 (0 Reviews)
About ASmith

Adam Smith is the main researcher and contributor at Mobility Medical Supply. Adam has many years of research in public data, and software security. With Mobility issues within Adam's family, he decided to dedicate in-depth guides on mobility products to anyone looking to improve movement and gain independence.

Leave a Comment