This article was updated February 12, 2020.
If you’ve suffered a foot or ankle injury and need an orthotic brace, Medicare may cover it. This applies for both custom-fitted foot and ankle braces as well as over-the-counter/off-the-shelf models. As long as your doctor deems it medically necessary and you buy the brace from a Medicare-approved supplier, Medicare will most likely cover it.
What Medicare covers
Medicare Part B will cover your foot and ankle braces if you:
- Are still able to walk;
- Need the foot or ankle to be stabilized due to weakness, injury, or deformity; and
- Have the potential to function better with a brace than without.
In order to qualify for a covered foot or ankle brace, you must undergo a physical exam with your doctor in a face-to-face consultation. Your general practitioner can perform this exam and prescribe your brace, but if you have a serious injury, you may need to see an orthopedic specialist.
Part B may also cover therapeutic shoes and orthotic inserts for people with diabetes who suffer from neuropathy and diabetic foot disease.
What Medicare does not cover
Medicare does not cover foot and ankle braces used for comfort or preventative purposes. Medicare is also unlikely to pay for any luxury add-ons like warming braces, circulation support, and additional comfort features.
Costs for foot and ankle braces
Medicare Part B covers foot and ankle braces as durable medical equipment (DME), which is medical equipment that may be used for multiple uses, up to several years.
After you’ve met the Part B deductible ($198 in 2020), Medicare will pay for 80 percent of the brace and you will be responsible for the remaining 20 percent.
Foot and ankle braces will only be covered by Medicare if they are purchased from a Medicare-approved medical supplier.
Beware of scams
Unfortunately, some Medicare beneficiaries get caught up in scams offering free orthotic braces. Scammers will often target unwitting Medicare beneficiaries and call them to inquire if they would like a free orthotic brace paid for in full by Medicare, even if they have not visited their doctor to ask for one.
The best way to get an orthotic foot or ankle brace is to visit your doctor and ask for one. Remember: no one from Medicare will call you, and they will not offer you free medical devices without a physical exam.
If you suspect Medicare fraud, you can report it to the Medicare fraud hotline. For beneficiaries with Original Medicare, call Medicare at 1-800-MEDICARE. TTY users call 1-800-486-2048.