Medicare offers coverage for compression socks only in specific situations so understanding the requirements for coverage is very crucial.

Does Medicare pay for compression stockings?

Generally, Original Medicare doesn’t cover compression stockings or other over-the-counter items like gauze and bandages because they don’t meet the criteria for durable medical equipment.

Medicare’s reimbursement is geared towards durable medical equipment (DME), including items ordered by a doctor for home use, deemed durable over several years, and medically necessary for treating an illness, injury, or medical condition.

While compression stockings meet some DME criteria, they fall short on the “durable” aspect. Given their single-user nature and limited duration of use, they don’t align with Medicare’s definition of durable medical equipment.

However, there’s a twist. In specific cases, if your doctor prescribes compression stockings to treat a venous stasis ulcer, Medicare Part B can step in for coverage.

Does Medicare Advantage cover compression stockings?

For those with Medicare Advantage (Part C) plans, the coverage  for compression stockings could be favorable. 

Since 2019, the Centers for Medicare & Medicaid Services (CMS) has empowered Medicare Advantage plans to broaden their covered benefits, introducing “supplemental benefits.” 

This category may include diverse offerings like meal delivery, transportation, and even home air purifiers for asthmatic patients.

Moreover, certain Medicare Advantage plans now provide a quarterly “over-the-counter” benefit, allowing you to allocate funds for various health purchases. 

This often spans medications, thermometers, and first aid supplies. Some plans may extend this benefit to cover compression stockings. 

To ascertain the specifics, please reach out to your Medicare Advantage provider and inquire about their coverage for compression stockings under supplemental benefits.

Does Medigap cover compression stockings?

Medigap plans, or Medicare Supplement Insurance, may assist in covering out-of-pocket expenses associated with Medicare-approved services, including compression stockings, if they are deemed medically necessary and covered by Medicare. 

However, it’s important to note that Medigap coverage is contingent on the services being approved by Medicare. If compression stockings are not considered a Medicare-approved item or service, Medigap coverage would not apply or extend to the associated costs of acquiring them. 

FAQs

Does Medicare cover compression stockings for lymphedema?

Yes, starting January 1, 2024, Medicare will cover lymphedema compression treatment items for Medicare Part B patients.

This is a condition characterized by swelling, usually in the arms or legs, due to a compromised lymphatic system.

To ensure coverage, the following conditions typically need to be met:

• Prescription: A healthcare provider must prescribe compression stockings as part of the treatment plan for lymphedema.
• Medical necessity: The stockings must be deemed medically necessary for the treatment of lymphedema, and the prescription should include details about the condition and the necessity of the stockings.
• Medicare-approved supplier: You should obtain compression stockings from a supplier that is enrolled in the Medicare program. Using a Medicare-approved supplier is crucial to ensure coverage.

Does Medicare cover compression stockings for venous insufficiency?

Medicare generally covers compression stockings for individuals with diagnosed venous insufficiency. The conditions and requirements are standard: 

• A prescription from a healthcare provider specifying the type and level of compression needed.
• The diagnosis made by a qualified healthcare professional.
• Purchase made from the suppliers that are enrolled in a Medicare program.  

We recommend that you verify the latest information by checking with Medicare directly, either through their official website (medicare.gov) or by contacting the Medicare helpline. 

Conclusion

The question of whether Medicare covers compression stockings is nuanced and depends on specific circumstances. While Original Medicare typically does not extend coverage for compression stockings, exceptions exist, particularly when prescribed to address venous stasis ulcers. 

The introduction of Medicare Advantage plans in 2019 has added a layer of possibility, with some plans offering coverage under supplemental benefits, including over-the-counter allowances.

To learn more about eligibility and coverage details, individuals are encouraged to directly contact their Medicare or Medicare Advantage providers, seeking clarity on this crucial aspect of vascular health support. 

In essence, proactive communication with healthcare providers and insurance carriers is essential to accessing the potential benefits Medicare may offer for compression stockings.