Does Medicare Pay for Walking Canes?

Medicare, a federal health insurance program, plays a significant role in managing healthcare costs for millions of Americans. It helps beneficiaries cover a wide array of medical services and supplies, contributing to overall health and well-being. The program is structured to provide financial assistance for various health needs, from hospital stays to medical equipment.

Medicare Coverage for Durable Medical Equipment

Medicare categorizes certain medical items as Durable Medical Equipment (DME), which are reusable items that serve a medical purpose, are typically used in the home, and are expected to last for at least three years. These items must not be useful to someone who is not ill or injured. Walking canes fall under the umbrella of DME and can be covered by Medicare.

Medicare Part B, which is the medical insurance component of Original Medicare, covers DME. For a walking cane to be covered, it must be deemed medically necessary. Medical necessity means a healthcare provider has prescribed the cane for a specific medical condition or injury, indicating it is essential for mobility, safety, or rehabilitation. This requirement ensures that the equipment directly addresses a health need and meets accepted standards of medicine.

Process for Obtaining a Covered Cane

First, a doctor or other healthcare provider, such as a nurse practitioner or physician assistant, must prescribe the cane. This prescription, also known as a written order, documents the medical necessity for the equipment and specifies the type of cane needed. Medicare requires that the doctor or provider be enrolled in Medicare for the prescription to be valid for coverage.

After receiving the prescription, the next step involves selecting a supplier. It is essential to choose a supplier that is enrolled in Medicare. To minimize out-of-pocket costs, it is advisable to choose a supplier who “accepts assignment.” Accepting assignment means the supplier agrees to accept the Medicare-approved amount as full payment for the cane. The supplier will then submit the claim directly to Medicare for payment.

Your Out-of-Pocket Costs

Even with Medicare coverage, beneficiaries typically incur some out-of-pocket expenses. For a Medicare-covered walking cane, after meeting the annual Medicare Part B deductible, you are generally responsible for 20% of the Medicare-approved amount. The Medicare Part B deductible for 2025 is $257.

If a supplier accepts assignment, they cannot charge you more than the Medicare-approved amount, limiting your financial responsibility to the deductible and the 20% coinsurance. If the supplier does not accept assignment, they may charge more than the Medicare-approved amount, and you could be responsible for the difference, in addition to your coinsurance and deductible. Supplemental insurance, such as Medigap policies or Medicaid, can often help cover these out-of-pocket costs, including the Part B deductible and coinsurance.