Does Medicare Cover Knee Braces?

Does Medicare Cover Knee Braces?

A knee brace offers support and stability. Your Medicare coverage depends on the type of knee brace your doctor prescribes.

There's no doubt that knee braces can increase a person's mobility in certain situations. Some types of knee braces are considered durable medical equipment (DME) and therefore are covered by Medicare. But not all of them.

This page looks at the types of knee braces, what they might be prescribed for, and how your Medicare coverage can help pay for the cost of a knee brace.

Who needs a knee brace?

Healthcare providers sometimes recommend knee braces to patients who need support around the knee to help stabilize or rehabilitate the joint. A knee brace helps the patient shift weight from the problem area of the knee to the healthy part. However, a knee brace can also alleviate pressure all over the knee to increase mobility.

Talk with your doctor to see if you can benefit from a knee brace.

Typically, knee braces can be helpful for those with osteoarthritis, which occurs when the padding between your joints wears down over your lifetime. About 30% of people suffer from this most common type of arthritis, and the knees are the most-affected joint. Osteoarthritis in the knee causes pain, swelling, and a reduced range of motion.

Knee braces may also be helpful for those who have knee injuries or bone spurs. A doctor may also recommend knee braces following surgery.

When will your doctor recommend a knee brace?

A healthcare provider may recommend a knee brace for any of the following four reasons:

To remove pain and pressure

A knee brace can take the pressure off the joint, reducing pain. Pain reduction can improve a person's mobility – especially for those with osteoarthritis.

To stabilize the knee

A knee brace can help stabilize the joint, especially after surgery or an injury. In certain situations, the knee may need to be held in place to ensure recovery. A knee brace can help with that process.

To rehabilitate the knee

Some healthcare providers may recommend a knee brace that allows limited mobility while healing.

To prevent injury

A knee brace can be used to give support to knees that were injured in the past. Such knee braces stabilize the joint and control motion to prevent additional injuries.

Again, talk with your doctor about whether a knee brace might help your situation. There's ongoing research about using knee braces, so it's essential to speak with a healthcare provider who stays current with the latest research. After all, a knee brace may hurt your situation more than help, so you should only wear one under a doctor's care.

Types of knee braces

There are three basic types of knee braces: hinged, wraparound, and sleeves.

Rigid hinged knee braces are stiff braces that immobilize the joint to support the knee. Some are semi-rigid and allow the patient to extend their knee further than if they were wearing a rigid brace.

Wraparound knee braces go around the knee and are held in place by tight straps. This type of knee brace relieves pressure and stabilizes the knee.

Knee sleeves and bandages slide over your foot up to your knee. They are used for mild knee issues and keep the joint warm and fluid. A knee sleeve offers limited stability to the joint.

Finally, knee braces can be open-patella or closed-patella. Open-patella braces have a hole above the kneecap. Your healthcare provider will determine the best type for your unique situation.

Does Medicare cover knee braces?

Yes, Medicare Part B (medical insurance) covers certain types of knee braces when prescribed by a doctor. To get Medicare coverage for a knee brace, you also have to purchase one from a participating DME supplier who accepts Medicare and the Medicare-approved price for the service or item.

The Medicare Braces Benefit covers a rigid or semi-rigid device used "for the purpose of supporting a weak or deformed body member or restricting or eliminating motion in a diseased or injured part of the body."

Elastic or other fabric support garments with or without stays or panels are not covered under the Medicare Braces Benefit. This means that if you want to get a wraparound, knee sleeve, or knee bandage for a mild knee condition, you can buy one off the shelf. It just won’t be covered by Medicare.

Cost and where to buy knee braces

After you meet your Medicare Part B deductible, you'll pay 20% of the Medicare-approved amount for the brace. It's worth noting that custom-fit knee braces range from $530 to $1,250.

To find a Medicare-approved DME supplier near you, use Medicare's DME supplier search tool (linked in the Additional resources section). Just enter your zip code and the type of equipment you need to find the closest supplier near you.

When you enter "knee brace" into the "search for medical equipment & suppliers" website, you'll be asked if you need an off-the-shelf knee brace or a custom-fit knee brace. Again, you may have to pay for your off-the-shelf brace.

Once you have selected the type of knee brace you need, the website will provide the business name, address, and phone number.

Medicare recommends contacting the supplier to confirm your needed equipment is in stock and to check the price. Please note that some DME suppliers agree to accept the Medicare-approved amount as full payment, which means you would pay less out-of-pocket.

Additional resources

After retiring from a career as an executive travel counselor in 2006, Donna Frederick embarked on a second career as a licensed insurance agent. During that first year, many clients told Donna how overwhelmed they felt by Medicare, but that her assistance helped them finally understand the Medicare program. That experience inspired Donna to focus her efforts on educating her clients to ensure they fully understand their Medicare options. Today, Donna takes pride in providing outstanding customer service and going the extra mile to make sure each client knows all of their options and has a sound understanding of their Medicare plan, from costs to coverage and all points in between.


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