Does Medicare Cover Orthotics?

Orthotics are devices used to treat injured muscles and joints. Medicare will typically cover 80 percent of the costs for orthotic devices under Medicare Part B if they are deemed medically necessary by a doctor. You are still responsible for 20 percent of the cost after you meet your deductible.

What Is an Orthotic Device?

An orthotic is a device used for supporting or treating injured or weakened muscles, joints and bones.

While orthotics are often associated with shoe inserts, there are several types to treat a variety of ailments.

Types of Orthotics
  • Therapeutic shoe inserts
  • Custom-molded shoes
  • Extra-depth shoes
  • Arm braces
  • Leg braces
  • Neck braces
  • Back braces

Orthotics are considered part of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS). This means that some of their costs are covered by Medicare.

Medicare Coverage of Therapeutic Shoes and Inserts

Therapeutic shoes and inserts have several uses. They are commonly used to support and protect the foot and can also alleviate pain. Inserts work by keeping too much pressure from impacting any one spot of your foot as you walk.

They can be used to treat many different issues, including loss of sensation, foot or toe deformities and plantar ulceration.

But therapeutic shoes and inserts are only covered under Medicare Part B if you have diabetes and severe diabetic foot disease.

If you meet those qualifications, you will be eligible each year for:
  • One pair of custom-molded shoes and inserts
  • One pair of extra-depth shoes
  • Two extra pairs of inserts for custom-molded shoes
  • Three extra pairs of inserts for extra-depth shoes

Medicare will cover 80 percent of the costs for therapeutic shoes and inserts. That leaves you responsible for 20 percent after your deductible has been met. The Medicare Part B deductible for 2021 is $203. Your doctor and supplier must be enrolled in Medicare.

The doctor who treats you for diabetes needs to deem the shoes or inserts medically necessary. They then must be prescribed by a qualified health care professional.

Health Care Professionals Who Can Prescribe Orthotics
  • Orthotist
  • Pedorthist
  • Podiatrist
  • Prosthetist
  • Other qualified professional

Medicare Coverage of Braces and Supports

Braces and supports are used to correct injuries, help stability and ease pain. They decrease the chance of additional injury and can also be used to help deformities.

Braces may be used as an alternative to surgery for some injury cases. There are some potential downsides to using braces, as they can result in loss of muscle function over time.

Common Types of Braces Covered by Medicare
  • Arm braces
  • Leg braces
  • Neck braces
  • Back braces

Braces must be deemed medically necessary by a health care professional. If they are, then Medicare will cover 80 percent of the cost. That leaves you with 20 percent after you’ve paid your deductible.

These types of braces and supports are also part of the DMEPOS Competitive Bidding Program. If you live in a competitive bidding area, you will need to make sure you are using a contract supplier in order for Medicare to help pay for an off-the-shelf back or knee brace.

Last Modified: August 5, 2021

5 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (n.d.). Therapeutic shoes & inserts. Retrieved from https://www.medicare.gov/coverage/therapeutic-shoes-inserts
  2. U.S. Centers for Medicare & Medicaid Services. (n.d.). Braces (arm, leg, back, and neck). Retrieved from https://www.medicare.gov/coverage/braces-arm-leg-back-neck
  3. U.S. Centers for Medicare & Medicaid Services. (n.d.). What Part B covers. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-b-covers
  4. Health Resources & Services Administration. (2017, April). Orthotics. Retrieved from https://www.hrsa.gov/hansens-disease/diagnosis/orthotics.html
  5. University of Maryland Medical Center. (n.d.) A Patient’s Guide to Back and Neck Braces. Retrieved from https://www.umms.org/ummc/health-services/orthopedics/services/spine/patient-guides/braces