Does Medicare Cover Prosthetic Devices?

Does Medicare cover prosthetic devices? Medicare does provide coverage for prosthetic devices, in most cases. This coverage is supplied through Medicare Part B, the outpatient benefit. Medicare Part B provides coverage for services like doctor visits, but it also covers durable medical equipment and related medical supplies.

Medicare Benefits Solutions

Jun 11, 2021

 3 minutes read

In order for a prosthetic device to qualify for coverage, it must be ordered by a doctor who participates in the Medicare program. Your cost will be 20% of the total amount for the device, and Medicare will cover the remaining 80%. This is the standard outpatient cost split that is used across most Part B coverage.

Does Medicare cover prosthetic devices in every state? Different states have different regulations regarding the coverage of certain types of prosthetics. For example, you may need to obtain prior authorization in order to obtain coverage for lower-limb prosthetic device coverage. To do this, you will want to work with your plan provider to ensure coverage.

Medicare and Coverage for Surgical Procedures
While some prosthetic devices can be fitted to your body without the need for surgery, others will require a surgical procedure that may require hospitalization. If you require inpatient hospitalization to receive your prosthetic device, Medicare Part A will help cover your hospital expenses.

If a device is fitted without hospitalization, Part B covers the service portion in most cases. You may find that a combination of Medicare Part A and Medicare Part B are utilized when you are faced with a situation requiring both hospitalization and the use of services offered by an outside provider.

Medicare Coverage for Physical Therapy and Rehabilitation
Some people require physical therapy and physical rehabilitation after receiving a prosthetic device. Additionally, follow-up appointments may be necessary if a prosthetic device requires monitoring or adjusting in the future.

Medicare covers these services under Part B as long as they are medically necessary and ordered by your doctor. Physical therapy that is ordered will need to take place in a Medicare-approved setting in order to be considered for coverage. This means that your physical therapist will also need to be approved by Medicare.

Medication Coverage After Receiving a Prosthetic Device
Medicare may also cover medications that are prescribed following the introduction of a prosthetic device. This may be the case when a prosthetic is surgically implemented, but it may also be the case to treat conditions that occur as the result of prosthetic device use.

If medications are prescribed, Medicare Part D will supply coverage as long as the medications are listed in your plan’s formulary. Medications not listed in your formulary may require a waiver to receive exception status for coverage.

Got questions?

Call a licensed sales agent at

877-406-1753 or TTY 771

Mon – Sun 5am to 8pm PST (Closed Thanksgiving)

Send us a message

We aim to reply within 24 hours.



    Medicare Benefits Solutions is a non-government website. This is a solicitation for insurance. By submitting information on this site, I am providing my written consent for Medicare Benefits Solutions, herein after referred to as “Medicare Benefits”, which is a brand operated by HealthCompare Insurance Services Inc., its sales agents, or affiliates to contact me (even if I’m on a state or national do not call registry) at the phone number or email address listed to provide me with quotes or information about Medicare Advantage, Medicare Supplement, and Medicare Part D plans. I further consent to such calls or texts sent via autodialer, automated technology, prerecorded message and/or artificial voice. I understand my consent is not a condition of purchase and that I can revoke my consent at any time via medicarebenefits.com/about-us/contact-us. Additional charges may apply to SMS, call, or Internet usage depending on your data providers.

    Find a plan

    Get plan recommendations

    Compare your current Medicare plan to our recommendations – then choose the plan that gives you more of the things you want.

    Find a new Medicare plan

    Click here to find out more

    Get a plan recommendation based on what's important to you.