Medicare covers medically necessary therapeutic devices. These include orthotics, like braces and supports, used to treat diseases of the feet, ankles, and legs related to conditions like diabetes.

Orthotics is the science of using devices like braces and splints to treat injuries, conditions, and irregularities of limbs and joints. Although the devices used in orthotics are often known as “orthotics,” they’re actually called orthoses.

Medicare covers medically necessary orthotic treatment, fittings, and orthoses.

Read on to learn who can prescribe orthotic treatment, which parts of Medicare cover it, and how to qualify for this coverage.

Medicare covers orthotic devices for people with diabetes and severe diabetes-related foot disease. It also covers medically necessary ankle-foot orthoses and knee-ankle foot orthoses.

Medicare will cover these orthotic devices and fittings once per calendar year.

Orthotic devices Medicare covers include:

  • custom-molded shoes and inserts (one pair per year)
  • extra-depth shoes (one pair per year)
  • inserts for custom-molded shoes (two pairs per year)
  • inserts for extra-depth shoes (three pairs per year)
  • shoe modifications instead of inserts

Depending on the circumstance, Original Medicare (Part A and Part B), Medicare Advantage (Part C), and Medigap may each cover part of the costs of orthotic care.

Medicare Part A

If orthotic services are provided as part of a hospital or Skilled Nursing Facility (SNF) admission, Medicare Part A may cover them.

They may be covered if the following conditions are met:

  • The orthosis is provided to a beneficiary before an inpatient hospital admission or an SNF stay covered by Part A.
  • The medical necessity for the orthosis begins during the hospital or SNF stay, such as after knee, ankle, or foot surgery.
  • The orthosis is provided to a beneficiary during an inpatient hospital or a Part A-covered SNF stay prior to the day of discharge.
  • The beneficiary uses the item for medically necessary inpatient treatment or rehabilitation.

Medicare Part B

Medicare Part B covers outpatient medical care. For orthotics, Part B covers braces, including ankle-foot orthoses and knee-ankle-foot orthoses, when medically necessary and if a Medicare-enrolled doctor or other healthcare professional orders them.

Medicare Advantage (Part C)

Medicare Advantage (Part C) plans must cover at least as much as Original Medicare. All plans would cover the same as Medicare Part B, but some may cover more than Part B.

Medigap

Depending on the Medigap plan, it may cover out-of-pocket costs like deductibles, copayments, and coinsurance for orthotic care.

It’s important to be sure that your doctor and the suppliers who provide your orthoses participate in Medicare. They must accept Medicare assignment for you to receive your full Medicare benefits.

If you choose a provider that does not accept Medicare assignment, they may charge you what they choose, and you’ll be responsible for paying that full amount.

Medicare Part A

If the cost of orthotics is paid by Part A, you may be responsible for the following charges related to your hospital or SNF stay:

Part A deductible

Part A deductible, which is $1,632 in 2024, for each inpatient hospital benefit period, before Original Medicare starts to pay.

Per day inpatient stay costs (hospital)

Additional costs you may need to pay vary depending on how long you’re admitted to a hospital or SNF. These fees are for all services you receive and include the following:

  • days 1 to 60: Part A deductible
  • days 61 to 90: $408 each day
  • days 91 to 150: $816 each day while using their 60 lifetime reserve days
  • after day 150: you’ll pay all costs

Per day inpatient stay costs (SNF)

  • days 1 to 20: the Part A deductible
  • days 21 to 100: $204 each day
  • days 101 and beyond: all costs

Medicare Part B

If Medicare Part B covers the cost of your orthotic treatment and orthoses, you’ll be responsible for your Part B annual deductible, which is $240 in 2024 and 20% of the Medicare-approved cost. Medicare will pay the remaining 80%.

Medicare Part C

Your out-of-pocket costs will vary depending on your specific advantage plan. Some plans include copays and deductibles.

Medigap

Depending on which Medigap plan you have, the plan may cover deductibles, copayments, and coinsurance related to your orthotic care.

For Medicare to cover orthotics care, the doctor must accept Medicare assignment and must be a qualified physician. A qualified medical doctor must prescribe all orthoses. And the orthoses must purchased from and delivered by one of these healthcare professionals:

  • a podiatrist
  • an orthopedist
  • a prosthetist
  • a pedorthist
  • another healthcare professional qualified in orthotics

Does Medicare cover arch support?

Medicare may cover arch supports if deemed medically necessary and prescribed by a doctor.

Do you need a prescription for orthotics?

You can purchase some types of orthoses over the counter. However, for your orthotic devices to be covered by Medicare, you need a prescription from a qualified doctor who accepts Medicare assignment.

Does Medicare cover shoes for neuropathy?

Yes, Medicare Part B may cover specific types of orthotic shoes for people with diabetes and diabetic neuropathy when deemed medically necessary and prescribed by a qualified healthcare professional. There may be other Medicare requirements for coverage.

Medicare covers orthotic treatment as long as it’s deemed medically necessary and prescribed by a qualified medical doctor. The coverage includes devices for people with diabetes and severe diabetes-related foot disease, as well as medically necessary ankle-foot orthoses and knee-ankle foot orthoses.

Medicare parts A, B, and C, as well as Medigap, may help cover the cost of your orthotic treatment.