Does Medicare cover prosthetics?

What prosthetics does Medicare cover?

Medicare Part B covers prosthetic devices, which replace a body part or function, when a doctor or other health care provider orders them. Artificial eyes, legs and arms are covered when they're medically necessary. Medicare.gov's examples of other Part B-covered prosthetic devices include:

• Breast prostheses (including a surgical bra)
• Enteral and parenteral nutrition, including nutrients, supplies and feeding pumps
• One pair of conventional eyeglasses or contact lenses after a covered cataract surgery
• Ostomy bags and certain related supplies
• Some surgically implanted prosthetic devices, including cochlear implants
• Urological supplies

Does Medicare cover a prosthetic leg or arm?

Yes. Medicare Part B covers medically necessary artificial legs and arms when a doctor or other health care provider orders them. Medicare requires prior authorization nationwide for certain types of lower-limb prosthetics before it will pay, a review that confirms Medicare's coverage rules are met before the item is delivered.

Does Medicare cover breast prostheses after a mastectomy?

Yes. Medicare Part A covers surgically implanted breast prostheses after a mastectomy if the surgery takes place in an inpatient setting, and Part B covers the surgery if it takes place in an outpatient setting. Part B also covers some external breast prostheses, including a post-surgical bra, after a mastectomy.

After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the doctor's services and the external breast prostheses. For surgery costs, see Does Medicare cover outpatient surgery?.

What do I pay for a prosthetic device?

After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount. Medicare only pays for a prosthetic device from a supplier that participates in Medicare, whether you or your provider submits the claim, and Medicare's equipment booklet says your amounts may be different if the supplier doesn't accept assignment.

What you owe also depends on any other insurance you have, how much your doctor charges, whether your doctor accepts assignment, the type of facility and where you get the device.

Does Medicare Advantage or Medigap change this?

Medicare Advantage plans cover almost all medically necessary services Original Medicare covers, and some offer extra benefits; in many cases you need to use providers in the plan's network, and costs vary by plan, so check with the plan before you get a prosthetic device. See What is the difference between Original Medicare and Medicare Advantage?.

With Original Medicare, a Medigap (Medicare Supplement Insurance) policy may help cover some of the costs of prosthetic and orthotic items, according to Medicare's equipment booklet.

Are eyeglasses after cataract surgery covered as a prosthetic?

Yes. Medicare Part B covers one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an intraocular lens. You pay 20% of the Medicare-approved amount after the Part B deductible, plus any extra cost for upgraded frames, and Medicare only pays if the supplier participates in Medicare. See Does Medicare cover cataract surgery?.