For those whose lives have been changed by the need for a prosthetic, these devices offer far more than just physical replacement — they also provide emotional restoration.
From artificial limbs and cochlear implants to heart valves and joint replacements, prosthetics can dramatically improve mobility and independence while also boosting confidence and emotional well-being. They help people return to daily activities, reconnect with their communities and reclaim a sense of self.
But these life-enhancing devices often come with a high price tag, making it crucial for Medicare beneficiaries to understand what is and isn’t covered. Knowing the eligibility requirements, coverage limits and potential out-of-pocket costs can make all the difference in securing the right prosthetic care without facing unexpected financial strain.
Navigating the ins and outs of Medicare, including which parts cover specific types of prosthetics, helps ensure beneficiaries receive the support they need to regain mobility, independence and quality of life without breaking the bank.
[READ Understanding Parts of Medicare: A Through N Explained]
What Are Prosthetics?
Prosthetic devices are used to replace body parts that are missing or no longer work. These devices may be needed due to injury, long-term wear and tear, disease or a congenital condition.
The purpose of a prosthetic device is to:
— Enhance appearance
— Improve mobility
— Increase independence
— Restore function
These artificial replacements are designed and often custom-fitted to the individual’s body and specific needs. The materials and technology used in prosthetics have advanced significantly and range from basic, functional devices to highly sophisticated, computer-controlled limbs that can mimic natural movement with precision.
Prosthetic devices fall into two categories: external prosthetic devices and surgically implanted prosthetic devices.
External prosthetic devices
An external prosthetic device, such as an artificial limb, is worn outside the body to replace a missing body part. Some key components of external prosthetic devices include:
— Covered under Medicare Part B if determined medically necessary
— Fitted and maintained by a prosthetist
— Require regular adjustments, maintenance and eventual replacement
— Typically removable
Surgically implanted prosthetic devices
Surgically implanted prosthetic devices, such as cochlear hearing implants, are devices placed inside the body during a surgical procedure to replace or support a body part that is no longer working as needed. Some key components include:
— Typically covered under Medicare Part A if the surgery is considered inpatient or Part B if the procedure is considered outpatient
— Often followed by rehabilitation or physical therapy
— Permanent or semi-permanent
[READ: Does Medicare Cover Medical Equipment?]
What Medicare Covers
Medicare covers many types of prosthetic devices as long as they are considered medically necessary.
“The criteria Medicare will use to determine medical necessity varies depending on the type of prostheses required and the patient’s current and potential functional abilities,” says Devon Bernard, assistant director of coding and reimbursement services, education and programming at the American Orthotic and Prosthetic Association (AOPA) in Alexandria, Virginia.
Some of the devices covered by Medicare include:
— Arm, back, leg and neck braces
— Artificial limbs and eyes
— Breast prosthesis, including a surgical bra
— One pair of eyeglasses or contact lenses after a covered cataract surgery that implants an intraocular lens
— Ostomy bags and supplies related to some bowel procedures
— Surgically implanted devices, including cochlear implants or heart valves
— Urological supplies like catheters and drainage bags
“Medicare does provide coverage for repairs and adjustments to a patient’s current prostheses, and this would include providing replacement components and even the provision of a replacement prostheses,” Bernard adds. “However, if the cost of the repairs is more than 60% of the cost of a replacement device or of the part being replaced, Medicare will cover a replacement prosthesis.”
[Read: Does Medicare Cover Incontinence Supplies?]
What Are the Costs?
While Medicare covers a significant portion of the cost, you may still have to pay coinsurance, copays or deductibles. The cost can add up as these devices can run in the thousands to tens of thousands of dollars. Different parts of Medicare cover different prosthetic devices.
— Part A (hospital insurance). If the device needs to be surgically implanted, this will fall under Part A coverage. You will need to satisfy your 2025 deductible of $1,676. If you need to spend time in the hospital after surgery, after the deductible is met, you pay nothing for the first 60 days. If you need a skilled nursing facility or rehabilitation stay afterward, after the deductible is met, you pay nothing for the first 20 days.
— Part B (medical insurance). Part B covers external prosthetics under durable medical equipment (DME). After you meet the Part B deductible, which is $257 in 2025, you pay 20% of the Medicare-approved amount. Keep in mind that depending on the state, you might need to get prior authorization for specific lower-limb prosthetics before Medicare will pay for them.
— Part C (Medicare Advantage). Medicare Advantage plans are obligated to provide the same coverage as original Medicare (parts A and B) and often provide additional benefits. However, cost sharing and eligibility requirements may vary. You will need to check with your plan to find out the specifics. If you currently use a prosthetic device and are considering switching to a Medicare Advantage plan, check the details to make sure you will have continued coverage.
| Deductible | 2025 Cost | Projected 2026 Cost |
| Part A | $1,676 | $1,716 |
| Part B | $257 | $288 |
Considering the potentially high cost of prosthetic devices, those with original Medicare may find it beneficial to add a Medigap plan to help cover their share of the expenses.
To have Medicare cover your prosthetic device, you need to obtain it from a supplier that is enrolled with Medicare. To find one near you, use Medicare’s supplier search feature.
Bottom Line
Prosthetic devices help restore function, mobility and emotional well-being by replacing missing or non-functional body parts.
Medicare covers many prosthetics if they are medically necessary, including both external devices like artificial limbs and surgically implanted ones like heart valves. Coverage depends on the type and setting: external prosthetics fall under Part B, while implanted devices are covered by Part A (inpatient) or Part B (outpatient).
Costs vary based on deductibles and Medicare plan type, with Medicare Advantage plans offering similar benefits but possibly different rules.
To receive coverage, the device must come from a Medicare-approved supplier contracted with your specific plan and include a doctor’s note explaining medical necessity.
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Does Medicare Cover Prosthetics? originally appeared on usnews.com
Update 10/10/25: This story was previously published at an earlier date and has been updated with new information.
