As the largest joint in the body, the knee supports the body’s weight, enables movement, and provides stability and flexibility. Because it plays such an important role, the knee can be vulnerable to injury and inflammation. Knee problems can be caused by overuse, an athletic injury, arthritis, gout, or infection. Minor injuries and moderate pain may benefit from self-care measures, including physical therapy and the use of a knee brace.

Knee pain can start as an occasional mild ache and may be treated with over the counter anti-inflammatory medications. If swelling, redness, weakness, or a decline in mobility occurs, it might be time to call your doctor. If you find that you can’t put weight on your knee, notice changes in the knee’s appearance, or experience limited extension, you should have it checked by your physician.

Your doctor will be able to determine the cause of your knee pain, and your treatment will depend on the diagnosis. You may have suffered an injury resulting in a tear in the ACL or meniscus, or a fracture from a fall. You may also be experiencing pain due to mechanical knee problems or from arthritis. Osteoarthritis is the most common form of arthritis for seniors due to the breakdown of cartilage as we age. Whether you are dealing with instability or pain, your doctor may create a treatment plan that includes using a knee brace. Knee braces provide protection and support, but they can vary. Hinged, compression, wraparound, or custom designs are used to address different needs.

How Medicare Can Help

If your doctor recommends a knee brace, your Medicare coverage may help pay for some of your costs. Medicare Part B (Medical Insurance) will cover medically necessary knee braces under its durable medical equipment (DME) benefit.

If you have Original Medicare, you will pay 20% of the Medicare-approved cost and the Part B deductible applies as long as your physician and supplier accept assignment and are currently participating in Medicare. Many people with Original Medicare decide to purchase supplemental insurance to help cover their out-of-pocket costs. If you have purchased a Medigap policy, it may help cover some of the coinsurance or deductible costs.

If you are enrolled in a Medicare Advantage plan, you will have at least the same Part A and Part B coverage as Original Medicare. Medicare Advantage plans are offered by private insurance companies and many offer additional benefits, including prescription drug coverage, vision and dental care, and annual out-of-pocket maximums. Call your MA plan to find your exact cost for a knee brace.

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