Does Medicare Cover Knee Braces? 

If you have one of these common knee injuries, your physician might suggest that you wear a knee brace:

• Sprains
• Ligament injury
• Patellofemoral pain syndrome (PFPS) also known as runner’s knee
• Instability in the kneecap
• Tendonitis
• Dislocated patella
• Peripheral neuropathy
• Arthritis

Wearing a knee brace – a medical device known as an orthotic – can help stabilize your knee joint, protect it from further harm, and support it after injury or surgery. 

What types of knee orthotics are available?

The most common types of knee orthotics are:

• Unloader braces are most prescribed for knee arthritis patients
• Patellofemoral braces support and protect the front of the knee and kneecap
• Knee immobilizer braces typically for those who are recovering from surgery to prevent most movement
• Functional braces commonly used after knee injury to provide support but allow movement
• Prophylactic braces worn to prevent knee injuries
• Knee sleeves made of tight elastic and used for knee support to prevent injury

If your physician recommends a knee brace, you might have Medicare coverage.

How does Medicare cover knee braces? 

If you’re enrolled in Original Medicare Part B, you can get coverage for knee braces under the durable medical equipment (DME) benefit if you qualify. Your health care provider (who accepts Medicare assignment) must certify that it’s medically necessary to treat your medical condition, or to help prevent one. 

Original Medicare Part B pays 80 percent of the approved cost to rent or purchase a knee brace from a medical supplier that accepts Medicare assignment. You pay the remaining 20 percent if you’ve already paid your Part B deductible for the year. 

If you’re enrolled in a Medicare Advantage (Part C) plan, your provider must cover at least all benefits covered by Original Medicare Parts A and B. Most MA plans also offer additional coverage and extra benefits, so you may have more options for knee braces and other types of DME. 

Some Medicare Advantage plans require that you use health care providers, medical facilities, and medical suppliers that are included in the plan’s network of providers to be eligible for coverage. 

Every Medicare Advantage plan sets its own coinsurance, copayment, and deductible charges, so you may pay a different amount for your DME. If you have questions about your MA plan’s network, coverage, or charges, contact your provider for help before making purchases or appointments for health care services. 

How much does a knee brace cost without Medicare insurance coverage? 

The cost of your knee brace depends on where you purchase it and what type you get. 
Here’s a list of the average cost for the most common types of knee brace cost across the country:

• Knee compression brace: $25 to $30
• Patella band knee brace: $20 to $25
• Patella strap knee support brace: $20 to $30
• Padded knee sleeve $70 to $100
• Breg brand knee braces $200 to $400

The type of knee brace that’s best for you depends on your medical condition, so it’s best to discuss your options with your doctor before making your final purchase.