Does Medicare Cover Canes?
Yes. Medicare Part B, part of Original Medicare, covers durable medical equipment (DME) such as canes. DME is defined as equipment prescribed by a physician that can withstand repeated use in the home and serves a medical purpose. Because canes are considered DME, Medicare Part B typically covers 80% of the cost, and beneficiaries are only responsible for the remaining 20%.
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The Benefits of Canes
Canes provide mobility support and can help you regain independence if you suffer from balance issues or muscle weakness due to aging, joint pain, are recovering from an injury, or have neurological conditions like Parkinson’s disease and multiple sclerosis.
Some common types of canes include:
- Standard canes: Standard canes offer an extra point of contact with the floor for balance and are made of wood or aluminum. They’re light and suitable for those who do not need much support.
- Quad canes: Quad canes are four-legged canes typically made of aluminum. Since they offer greater stability, quad canes are more suitable for those who suffer from serious balance issues or weakness.
- Seat canes: As the name suggests, a seat cane comes with a seat, allowing users to sit down and rest when they need a break.
- Offset canes: Offset canes have a curved handle that look like a swan’s neck, providing a more comfortable grip, and are suitable for those with arthritis or wrist problems.
Understanding Medicare’s Coverage of Canes
Canes can help you regain your freedom when you suffer from mobility issues, but it might not be affordable for everyone. Here’s how Medicare’s coverage of canes works.
You must meet the following eligibility requirements to get your cane covered by Medicare:
- You must be enrolled in Original Medicare or Medicare Advantage
- Your physician and DME supplier must accept and participate in Medicare
- Your physician must provide proof that a cane is medically necessary for your circumstances
Part A Coverage
Medicare Part A, also known as Hospital Insurance, is the component of Original Medicare that covers inpatient hospital services, such as skilled nursing facility care, hospice care, and some home health care services. However, Medicare Part A generally does not cover durable medical equipment like canes.
Part B Coverage
Medicare Part B covers outpatient care like doctor’s visits, preventive services, durable medical equipment, and other services that Part A does not cover. In the context of canes, Medicare Part B typically covers them when they’re prescribed by a doctor as medically necessary.
For Medicare Part B to consider an item DME, it must be
- Durable and can withstand repeated use
- Expected to last at least three years
- Used for a medical reason
- Only useful to someone who’s injured or ill
- Used in your home
How Does Medicare Advantage Cover Canes?
Medicare Advantage, also known as Medicare Part C, is a health insurance plan offered by private insurers approved by Medicare. By law, Medicare Advantage plans must, at minimum, provide all the coverage offered by Medicare Parts A and B. In other words, Medicare Advantage plans must offer the same coverage for DME as Original Medicare when it’s prescribed by a doctor as medically necessary.
How Much Do Canes Cost With Medicare?
Without insurance coverage, canes can range from $10-$100 or more depending on the type and features. Generally, you can find standard canes online for $10-$30 and quad canes or seat canes for $30-$100. If you’re on a tight budget and cannot afford one, Medicare’s coverage could lower your out-of-pocket costs.
Part A Costs
Medicare Part A typically covers inpatient hospital care with no monthly premium for most beneficiaries. However, it does not cover durable medical equipment like canes.
Part B Costs
Before Medicare Part B covers your cane, you must first meet the annual deductible, which is $240 in 2024. Besides the deductible, you must also pay a standard Part B monthly premium of $174.70. After you’ve paid those expenses, Medicare Part B will cover 80% of the approved DME costs, leaving you responsible for the remaining 20%.
Medicare Advantage Costs
While Medicare Advantage’s cover aligns with Part B guidelines, the different plans typically have monthly premiums, copayments, and deductibles that vary by plan. Check with your specific Medicare Advantage plan for more details on your DME out-of-pocket costs.
How to Get a Medicare-Covered Cane
Here’s how to get a Medicare-covered cane if you have trouble walking and need financial assistance to restore mobility.
- Get a Doctor’s Prescription: Schedule a visit with your doctor to discuss your mobility needs and get a prescription for a cane if deemed medically necessary.
- Choose a Medicare-Approved Supplier: Once you have a prescription from your doctor, choose a supplier enrolled in the Medicare program. Use Medicare’s tool to find DME suppliers in your area.
- Submit Prescription to Your Supplier: Provide the supplier with your doctor’s prescription or order, and they’ll typically initiate the claims process with Medicare on your behalf.
- Choose a Suitable Cane: Select a cane from the supplier that meets Medicare’s criteria and aligns with your mobility needs.
All in All
While canes typically cost less than $100, they can still put a dent in a tight budget. Without Medicare’s coverage, those facing financial constraints may have trouble accessing this mobility aid. To ensure your cane is covered by Medicare Part B, make sure it’s prescribed by your doctor, meets Medicare’s durable medical equipment criteria, and is purchased from a Medicare-approved supplier. If you have any questions or concerns about your coverage or the claims process, contact Medicare at 1-800-633-4227.