Prosthetic and Orthotic Medicare covered list and how much patient responsibility

Prosthetic and Orthotic Items covered by Medicare.

What Medicare Covers

•Arm, leg, back, and neck braces
•Artificial limbs and eyes
•Breast prostheses (including a surgical brassiere) aftera mastectomy
•Ostomy supplies for people who have had acolostomy, ileostomy, or urinary ostomy. Medicarecovers the amount of supplies your doctor says youneed based on your condition.
•Prosthetic devices needed to replace an internal bodypart or function
•Therapeutic shoes or inserts for people with diabeteswho have severe diabetic foot disease The doctor who treats your diabetes must certifyyour need for therapeutic shoes or inserts. Apodiatrist or other qualified doctor must prescribethe shoes and inserts.

A doctor or other qualifiedindividual like a pedorthist, orthotist, or prosthetistmust fit and provide the shoes. Medicare helps payfor one pair of therapeutic shoes and inserts percalendar year. Shoe modifications may besubstituted for inserts.

What You Pay
You pay 20% of theMedicare-approved amount afteryou pay your Medicare Part Bdeductible for the year ($135 in2009).Medicare pays the other80%. These amounts may bedifferent if the supplier doesn’taccept assignment.