Medicare covers durable medical equipment like prosthetics under Part B. However, you may need to meet specific criteria to ensure the prosthetic you need is covered.
Prosthetic limbs may be the first things that come to mind when considering prosthesis devices. However, several other items are also included in this category, and Medicare offers coverage whenever they’re considered medically necessary.
Prosthetic devices are covered under Medicare Part B as durable medical equipment (DME). In many cases, the cost is almost entirely covered.
Find out what you need to know to get coverage for your prosthetic device.
Prosthetic devices include a wide variety of items to help any part of your body that is damaged, removed, or stops working.
When you think of prosthetic devices, body parts like arms or legs might come to mind, but this category includes far more devices.
Some of the prosthetic devices covered by Medicare include:
- arm, leg, back, and neck braces
- breast prostheses, including a surgical bra
- eyeglasses or contact lenses after cataract surgery with an intraocular lens implant
- ostomy bags and supplies related to some bowel procedures
- prosthetic limbs and eye implants
- surgically implanted devices, including cochlear implants
- therapeutic shoes for people with foot problems related to diabetes
- urological supplies like catheters and drainage bags
If you need an external prosthetic device, it’ll be covered as DME under Medicare Part B. If you’ve chosen a Medicare Advantage (Part C) plan instead of Original Medicare (parts A and B together), your plan will still cover this equipment.
Medicare Advantage plans must cover at least as much as Original Medicare, and many also offer additional coverage. If you have a Medicare Advantage plan, check the plan details to find out exactly what’s covered and how much you’ll have to pay.
With Medicare Advantage, you may be limited to certain in-network suppliers or facilities when it comes to obtaining your device, depending on your plan’s rules.
If your prosthetic device is surgically implanted, this usually requires a hospital stay. In this case, your device will be covered under Medicare Part A, which covers inpatient hospital care.
Your doctor must order your prosthetic device as a medically necessary replacement for a body part or bodily function for it to be covered by Medicare.
The doctor prescribing the device must:
- be enrolled in the Medicare program
- detail why you need the device
- confirm that the device is a medical necessity
You must also ensure that your device’s supplier is enrolled in the Medicare program.
To check whether your supplier is enrolled in and participating in the Medicare program, you can use Medicare’s website to find provider and supplier tools.
If you have a Medicare Advantage plan, you may be restricted to certain providers or suppliers within your coverage network. Check with your plan before renting or ordering any equipment.
You may also have additional coverage with a Medicare Advantage plan. While Original Medicare covers only medically necessary items in certain situations, a Medicare Advantage plan may offer extra coverage for things like glasses or hearing aids.
Your plan can provide details on exactly what items are covered and how much they’ll cost.
Not every prosthetic device is considered medically necessary. Several prosthetics and implants are considered cosmetic, so Medicare does not cover them. Some devices that wouldn’t be covered include:
- cosmetic breast implants
- dentures
- eyeglasses or contact lenses for most patients
- wigs or head coverings for hair loss
Depending on your plan, some of these items may be covered by Medicare Advantage. Medicare Advantage plans usually include extra coverage that Original Medicare doesn’t, including care for:
- dental
- vision
- hearing
If there are devices you need or ones you want your plan to cover, you can search for a plan that includes those items when signing up for Medicare Advantage.
Medicare will cover your prosthetic device in the same way as other DME or implants if it meets the following criteria:
- medically necessary
- not simply cosmetic
- ordered by a physician who participates in the Medicare program
- obtained from a supplier that participates in Medicare
Costs with Part A
If your prosthesis needs to be surgically implanted, it will be covered under Medicare Part A as part of an inpatient procedure.
This means you’ll pay your Part A deductible and premium (although most people won’t pay a premium for Part A). For 2025, the deductible is $1,676. Beyond that, you’ll have no copayment for your first 60 days in the hospital.
Part A also covers a stay in a skilled nursing facility or rehabilitation center after surgery.
You’ll pay nothing extra for the first 20 days of care in a skilled nursing facility. After that, daily costs increase as your stay is extended.
The facility and Medicare will cover any additional equipment you need while you’re in the facility, such as a wheelchair, walker, orthotics, and more.
Costs with Part B
Many prosthetics, like surgical bras and orthotics, don’t require surgery. They can be used as complementary devices at home. Part B will cover the device under its DME category in this case.
Your premium for Part B is $185.00 each month for 2025. If you meet the coverage criteria, Medicare will cover 80% of the approved equipment cost once you meet your deductible of $257, and then you’ll pay the remaining 20%.
If your device cost exceeds the amount Medicare allows, you’ll pay 100% of the excess.
You must also pay your monthly Part B premium and meet your annual deductible before covering your equipment.
Costs with Part C
The amount you’ll pay for a prosthetic device with a Medicare Advantage plan is much more variable. All Medicare Advantage plans must offer at least the same coverage as Original Medicare, but most plans offer more.
The exact coverage and cost will depend on the plan you choose. Discuss coverage and cost specifics when signing up for your Medicare Advantage plan, if possible.
Learn more: “Choosing a Medicare Advantage Plan That’s Right for You“
Costs with Medigap
Another option for coverage of prosthetic devices is Medicare supplemental insurance, also known as Medigap.
Medigap plans are private insurance products that can be used only with Original Medicare, not Medicare Advantage.
Costs vary by plan, but these policies can help offset out-of-pocket Medicare costs. Some examples of what Medigap plans can be used for include:
- Part A coinsurance, copayment, deductible, and hospital costs
- Part B coinsurance, copayment, deductible, and excess costs
What if I have more questions about prosthesis coverage?
If you have specific questions about prosthetic device coverage, you can contact Medicare or your local State Health Insurance Assistance Program (SHIP) center. Your doctor also may be able to provide information and supplier lists.
If you’ve been denied coverage for a device, you can appeal the decision by filing an appeal with Medicare.
Medicare covers prosthetic devices as long as you meet certain criteria. Medicare Part B covers most external prosthetic devices; Medicare Part A covers devices that must be surgically implanted.
Only medically necessary devices are covered under Medicare Part B, and you’ll pay 20% of the cost. Medicare Advantage plans can provide additional coverage, but you should review coverage and costs for prosthetic devices before signing up.