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Does Medicare Cover Orthotics? Braces, Shoe Inserts and What You Pay (2026-2027)

Updated November 11, 2026

Reviewed November 11, 2026. Yes, Medicare covers many orthotics. Medicare Part B covers arm, leg, back and neck braces when they are medically necessary, ordered by your doctor or other health care provider, and supplied by a Medicare-enrolled supplier. Foot orthotics and shoe inserts on their own are a different story: Medicare generally covers them only when they are an integral part of a covered leg brace, or under the therapeutic shoe benefit for people with diabetes and severe diabetic foot disease.

What counts as an orthotic for Medicare

Medicare describes braces as rigid or semi-rigid devices that support a weak or deformed body part, or that restrict or eliminate movement of an injured one. Common examples include knee braces, back braces (lumbar-sacral and thoracic-lumbar-sacral orthoses), ankle-foot orthoses (AFOs), neck collars and wrist or arm braces.

Medicare groups braces with artificial limbs and eyes under its prosthetics and orthotics benefit, and handles them through the same supplier system as durable medical equipment (DME). Braces come in three broad forms:

All three can be covered when medical necessity rules are met. The type matters mainly for documentation, prior authorization and, starting in 2028, competitive bidding (see below).

Braces vs. shoe inserts: the key difference

Many people searching for “orthotics” mean shoe inserts or arch supports. This is where Medicare coverage is narrowest. Under federal law, orthopedic shoes, inserts and shoe modifications are excluded from coverage except in two situations:

  1. The shoe is an integral part of a covered leg brace. For example, a shoe attached to a leg brace that needs it to work properly. Inserts or modifications on that shoe can be covered if they are medically necessary for the brace, and the same supplier must bill the shoe and the brace.
  2. You qualify for the diabetic therapeutic shoe benefit. This is a separate Part B benefit, explained in the next section.

Outside those cases, Medicare denies claims for shoes and inserts as statutorily excluded, even with a prescription. That means custom foot orthotics for conditions such as flat feet or plantar fasciitis, by themselves, are generally not covered by Original Medicare. If a supplier suggests otherwise, ask for a written explanation before you pay.

Therapeutic shoes and inserts for people with diabetes

If you have diabetes and severe diabetic foot disease, such as a foot ulcer or foot deformity, Part B can cover therapeutic shoes and inserts. Each calendar year you can get one of these:

In some cases Medicare may cover shoe modifications instead of inserts. To qualify:

Some brands market diabetic footwear that may fit this benefit. Our guide to Medicare and Orthofeet shoes walks through one example. For other diabetes items, see Medicare Part B diabetic supplies.

What you pay for orthotics with Original Medicare

Braces and diabetic shoes follow standard Part B cost-sharing:

Cost2026 amount
Part B annual deductible$283
Coinsurance after the deductible20% of the Medicare-approved amount
Standard Part B monthly premium$202.90
2027 figuresNot yet published by CMS as of November 11, 2026

Example: If the Medicare-approved amount for a brace is $500 and you have already met your 2026 deductible, you would owe $100 (20%) to a supplier that accepts assignment. Actual approved amounts vary by item and location.

Assignment matters. A participating supplier must accept assignment, so it can charge you only the deductible and coinsurance based on the Medicare-approved amount. A supplier that doesn’t accept assignment can charge more, and you may have to pay the full amount upfront and wait for Medicare to reimburse its share. Always ask before you order.

Prior authorization for certain braces

Original Medicare usually doesn’t require approval in advance, but CMS keeps a Required Prior Authorization List for certain DMEPOS items. For listed items, prior authorization is a condition of payment, and your supplier handles the request. As of the list updated July 29, 2026, orthoses requiring prior authorization nationwide include:

Since January 1, 2025, CMS has a 7-calendar-day target for standard prior authorization decisions and 2 business days for expedited requests. If your supplier says your brace needs approval, expect a short wait before delivery.

Competitive bidding for off-the-shelf braces (coming 2028)

CMS has announced that the next round of the DMEPOS Competitive Bidding Program will include off-the-shelf back braces, knee braces and upper extremity braces. Contracts are expected to take effect no later than January 1, 2028. Once in place, you may need to use a Medicare contract supplier for those braces, and contract suppliers must accept assignment. Nothing changes for 2026 or 2027 under this round.

How to get orthotics covered by Medicare

  1. See your doctor. Your doctor or other provider evaluates you and documents why the brace is medically necessary. Both the prescriber and the supplier must be enrolled in Medicare.
  2. Get a written order. The order should describe the specific item you need.
  3. Choose an enrolled supplier that accepts assignment. You can search suppliers using Medicare’s “Find medical equipment & suppliers” tool on Medicare.gov.
  4. Let the supplier handle prior authorization if your brace is on the required list.
  5. Confirm the supplier bills Medicare. With assignment, you pay only your deductible and 20% coinsurance.

If you already received a similar item recently, Medicare may deny a replacement. Learn how that works in our guide to the same or similar policy for DME. If you also need mobility equipment, see Medicare coverage for wheelchairs.

Medicare Advantage, Medigap and Medicaid

Medicare Advantage (Part C)

Medicare Advantage plans must cover all medically necessary services that Original Medicare covers, so medically necessary braces and diabetic therapeutic shoes are covered. Your costs and rules can differ. Plans may require you to use in-network suppliers and get prior authorization or a referral. Copays or coinsurance for DME and orthotics vary by plan and county, so check your plan’s Evidence of Coverage. Some plans may offer extra benefits, but don’t assume foot inserts are included unless your plan documents say so.

Medigap (Medicare Supplement Insurance)

If you have Original Medicare, a Medigap policy can help pay your Part B coinsurance for covered orthotics. Plan N pays 100% of Part B coinsurance (with some office and ER copays), Plan K pays 50% and Plan L pays 75%. Medigap does not pay for items Medicare doesn’t cover, such as excluded foot inserts. You can’t use Medigap with a Medicare Advantage plan.

Medicaid and Medicare Savings Programs

Prosthetics are an optional Medicaid benefit, so coverage for braces and orthotic devices beyond what Medicare pays depends on your state. If you qualify for the Qualified Medicare Beneficiary (QMB) program, it pays your Part B deductible and coinsurance, and Medicare providers generally can’t bill you for those amounts. Contact your state Medicaid agency for details.

Frequently asked questions

Does Medicare cover custom foot orthotics?

Generally no. Custom foot orthotics and inserts are excluded unless they are part of a covered leg brace or you qualify for the diabetic therapeutic shoe benefit.

Does Medicare cover knee and back braces?

Yes, when medically necessary and ordered by your provider. Many knee and back braces now require prior authorization, which your supplier requests.

Will Medicare pay for braces I buy at a drugstore?

Medicare pays only when a Medicare-enrolled supplier furnishes the item based on a valid order and submits a claim. A brace you buy off a store shelf without that process generally won’t be reimbursed.

How many diabetic shoes does Medicare cover each year?

One pair per calendar year: either extra-depth shoes with three pairs of inserts, or custom-molded shoes with two extra pairs of inserts.

What will I pay for a brace in 2027?

You will still pay 20% coinsurance after the Part B deductible. CMS had not announced the 2027 deductible as of November 11, 2026; the 2026 deductible is $283.

Sources

Medicare365