Does Insurance Cover Crutches and Durable Medical Equipment

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Walking Crutches
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Most health insurance plans cover some form of durable medical equipment, including crutches.

Crutches are considered medically necessary if prescribed by a doctor, and insurance companies will typically cover them.

Many insurance plans have a specific list of covered items, which may include crutches, walkers, and wheelchairs.

Some insurance plans may also cover additional items, such as orthotics and prosthetics.

Insurance coverage for crutches and durable medical equipment can vary depending on the type of insurance plan and the individual's specific needs.

Insurance Coverage

Insurance Coverage can be a bit confusing, but let's break it down. Your insurance may cover a hands-free crutch, but you'll need to check with your plan provider to determine your specific benefits.

The amount of coverage and out-of-pocket costs depend on several factors, including your private medical insurance plan, provider, annual deductible, and co-pay requirements. It's essential to understand these factors to avoid any surprise costs.

If you're eligible for Medicare benefits, your Part B insurance can help pay for the cost of your crutches while you need them. Medicare Part B helps cover the costs of durable medical equipment (DME) prescribed by your physician, including crutches.

From above composition of stack of USA dollar bills placed near medical protective masks produced in China illustrating concept of medical expenses and deficit during COVID 19
Credit: pexels.com, From above composition of stack of USA dollar bills placed near medical protective masks produced in China illustrating concept of medical expenses and deficit during COVID 19

To be eligible for Medicare coverage, your physician must be enrolled in Medicare, and the medical equipment supplier must accept assignment. This ensures you pay 20% of the Medicare-approved amount and the Part B deductible applies.

Here are some types of crutches that may be covered under Medicare:

  • Axillary Crutches: The most common form of crutches, can be adjusted depending on your height
  • Forearm Crutches: Also known as an elbow crutch, recommended for use in life-long disabilities
  • Platform Crutches: The “triceps crutch” provides stability with a lower cuff below the back of the elbow to avoid contact with bones

Keep in mind that your Medicare Advantage (MA) plan may offer additional benefits, so it's best to talk to your plan directly to find out your exact costs.

Cost and Types

Crutches are considered a type of Durable Medical Equipment (DME) covered by Medicare, which includes canes, wheelchairs, walkers, and oxygen equipment.

Some examples of DME that are covered by Medicare include canes, crutches, wheelchairs, walkers, oxygen equipment, hospital beds, blood sugar monitors, and Continuous Glucose Monitors (CGMs).

You can expect to pay out-of-pocket for these items if you don't have insurance that covers DME.

Cost of Hands-Free Crutches

The cost of hands-free crutches can be a significant factor in your decision to purchase one. The average cost of a hands-free crutch without insurance is around $150.

Unhappy woman with trauma in leg sitting on sofa and leaning on crutches
Credit: pexels.com, Unhappy woman with trauma in leg sitting on sofa and leaning on crutches

Newer models designed for single patient use are lighter and considerably lower in cost, which is a relief for those on a budget. These models can be a more affordable option.

Insurance coverage for hands-free crutches varies depending on your provider and plan. A hands-free crutch may be covered by your insurance, but it's essential to check with your plan provider to determine your specific benefits.

The amount of coverage and out-of-pocket costs you'll pay depend on factors such as your private medical insurance plan, provider, annual deductible, and co-pay requirements.

Types of DME and Supplies

Medicare covers a wide range of durable medical equipment (DME) and supplies to help you manage your daily activities and maintain your independence.

Medicare covers canes, crutches, wheelchairs, walkers, oxygen equipment, hospital beds, and blood sugar monitors. These devices can make a huge difference in your quality of life, especially if you're recovering from an injury or surgery.

A Girl in a Pink Dress Standing with a Crutch
Credit: pexels.com, A Girl in a Pink Dress Standing with a Crutch

Here are some examples of DME and supplies covered by Medicare:

  • Canes
  • Crutches
  • Wheelchairs
  • Walkers
  • Oxygen equipment
  • Hospital beds
  • Blood sugar monitors
  • Continuous Glucose Monitors (CGMs) - examples include Dexcom and Libre

Medicare can also cover other types of DME, such as hospital beds, which can be a lifesaver if you need to rest or recover at home.

Specific Questions

If you've recently broken an ankle or suffered another injury that requires crutches, you're probably wondering if your insurance will cover the cost.

Most health insurance plans cover crutches as a medical necessity, including Medicare and Medicaid.

Typically, insurance companies will cover the cost of crutches for a period of time, usually up to 6 months.

You can expect to pay a copayment or coinsurance for the crutches, depending on your insurance plan.

Insurance companies may require a doctor's note or prescription to approve coverage for crutches.

Some insurance plans may have specific requirements for crutch coverage, such as a minimum number of doctor visits or a certain level of disability.

Frequently Asked Questions

Do you get a prescription for crutches?

A prescription for crutches is typically only given by a healthcare provider for specific injuries, such as an Achilles tendon rupture or tendinitis. If you're experiencing pain or discomfort, consult a healthcare professional for proper diagnosis and treatment.

How much do crutches cost without insurance?

A hands-free crutch typically costs around $150 without insurance, with newer models being significantly more affordable than original models.

Greg Brown

Senior Writer

Greg Brown is a seasoned writer with a keen interest in the world of finance. With a focus on investment strategies, Greg has established himself as a knowledgeable and insightful voice in the industry. Through his writing, Greg aims to provide readers with practical advice and expert analysis on various investment topics.

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