Medicare and Compression Stockings
Compression stockings are designed to improve blood flow in the legs. These stockings are used to prevent the development of venous disorders such as thrombosis, edema, and phlebitis. Compression stockings place pressure on your legs, making it easier for venous blood (unoxygenated blood) to return to the heart.
Better blood flow prevents blood from pooling in the vein and making a clot. The danger with blood clots is if one breaks free, it could travel to your lungs and get wedged into an artery. These clots could lead to pulmonary hypertension, a condition where blood pressure in the right of the heart becomes too high.
People who are suffering from spider veins, varicose veins, and especially those who just had surgery are advised to wear compression stockings. This advice is especially crucial for post-surgery patients as prolonged immobility or those recommended for bed rest are at higher risk for developing blood clots.
Will Medicare Cover Compression Stockings?
Generally, Medicare does not cover compression stockings. Original Medicare (Part A and Part B) do not cover compression or diabetic socks. This even when a doctor prescribes the use of compression stockings. However, there is one exception. Medicare provides coverage when gradient compression is used for treating open venous stasis ulcers.
When these are used for open venous stasis ulcers, gradient compression can now be considered as a wound dressing which is covered under Medicare Part B. The cost of gradient compression stockings will only be covered if these are worn below the knee and compression is greater than 30mm Hg but less than 50mm Hg.
Medicare does provide coverage for some devices similar in function to compression stockings. It includes lymphedema pumps which are also used to improve blood circulation in the lower extremities. A pneumatic compression device uses cuffs that are wrapped around the legs and filled with air. The pumping action inflates and deflates the device based on cycle times.
Lymphedema or pneumatic compression devices can help treat conditions such as chronic venous insufficiency in venous stasis ulcers and lymphedema. These devices can only be covered when a physician prescribes this and determined to be medically necessary.
How Much Will Medicare Pay For?
Original Medicare (Part A and Part B) does not cover compression stocks. Medicare coverage is also not available for common medical supplies, including bandages and gauzes. However, Medicare does provide coverage for durable medical equipment, which includes but not limited to infusion pumps, crutches, walkers, canes, and manual wheelchairs.
In cases where treatments and services are covered, beneficiaries should be ready to pay out-of-pocket costs such as co-payments, coinsurance, and deductibles. Medicare will pay for 80 percent of Medicare-approved costs while the beneficiary shoulders the remaining 20 percent.
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