Coffee & Coverage: Will Medicare Cover Your Back Brace?

If you’re in need of a back brace (lumbosacral orthosis) due to back pain or recovering from surgery, you may be wondering if Medicare will cover it.

Medicare will cover back braces as long as they are deemed medically necessary durable medical equipment (DME) and prescribed by a doctor. Medicare Part B covers 80 percent of the cost, while you cover 20 percent, plus any Part B deductible that is left. A Medigap plan can help you cover your part of the cost.

If you have Medicare Advantage, your coverage should work the same. Contact your plan to see what amount will be covered for your back brace.

Reasons you might need a back brace

There are many reasons one might need a back brace, including:

  • Lower back pain
  • Recovering from surgery
  • Compression fractures
  • Alleviating pressure on the spine
  • Supporting weakened muscles
  • Helping with good posture

When Medicare covers DME

Medicare Part B covers durable medical equipment (DME) as long as the equipment:

  • Is durable and strong
  • Can last at least 3 years
  • Is used at home
  • Provides therapeutic use for the medical condition for which it is used 
  • Is deemed medically necessary by your doctor

Back brace scams and Medicare

Be aware that there are many scams occurring surrounding back braces and Medicare. These include ads on TV and unsolicited callers who will offer you a back brace and ask for your Medicare information.

Do not fall for these traps. Be sure to get a back brace through a reputable, Medicare-approved supplier recommended by your doctor. 

Need more information?

Find a Supplier of Durable Medical Equipment here: https://www.medicare.gov/supplierdirectory/search.html

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