Medicare's coverage of compression socks depends on whether a doctor prescribes them as medical treatment, not as over-the-counter comfort wear

Medicare Part B covers compression stockings when a doctor writes an order stating they are medically necessary for a specific condition. The socks must be prescribed, not purchased on your own. Medicare will pay 80 percent of the approved amount after you meet your Part B deductible, and you pay the remaining 20 percent. If you have a Medigap or Medicare Advantage plan, your out-of-pocket cost may be lower.

Over-the-counter compression socks that you buy yourself at a drugstore or online are not covered, even if they are the same product a doctor might prescribe. The difference is the prescription and the medical reason documented in your chart.

Key Takeaways

  • Medicare Part B covers compression stockings only when a doctor prescribes them as treatment for a medical condition such as lymphedema, venous insufficiency, or deep vein thrombosis.
  • You must have a written prescription from your doctor; buying compression socks on your own does not may have access to for coverage.
  • You pay 20 percent of the Medicare-approved amount after meeting your Part B deductible; the exact cost depends on the brand and supplier.
  • Medicare Advantage and Medigap plans may cover compression stockings differently, so check your plan documents or call your plan before ordering.

What conditions may have access to for coverage

Medicare covers compression stockings for conditions that affect blood flow in the legs. The most common reasons are lymphedema (swelling caused by fluid buildup), venous insufficiency (when leg veins do not pump blood back to the heart properly), and a history of deep vein thrombosis (blood clots in the legs). Your doctor must document in your medical record that compression stockings are medically necessary to treat or prevent worsening of one of these conditions.

Your doctor does not need to use specific language, but the prescription should state the medical reason and the compression level needed (usually measured in millimeters of mercury, or mmHg). Medicare reviewers will look at your chart to confirm the condition exists and that compression stockings are an appropriate treatment.

How to get a prescription from your doctor

Start by telling your doctor that you have leg swelling, pain, or other symptoms that make you think compression stockings might help. If your doctor agrees they are medically necessary, ask for a written prescription. The prescription should include the compression level (for example, 15–20 mmHg or 20–30 mmHg), whether you need knee-high or thigh-high stockings, and the quantity (usually one or two pairs per month).

Give the prescription to a Medicare-approved supplier, not to a retail store. Your doctor's office may have a preferred supplier, or you can search for one on the Medicare website under "Durable Medical Equipment Suppliers." The supplier will submit the prescription and your information to Medicare for review before you receive the stockings.

What Medicare actually pays

Medicare sets an approved amount for compression stockings based on the type and compression level. The approved amount varies but typically ranges from $40 to $100 per pair, depending on the supplier and the specific product. You are responsible for 20 percent of the approved amount after you have met your Part B deductible for the year.

If the supplier charges more than Medicare's approved amount, you do not pay the difference — the supplier must write it off. This is called "accepting assignment." All Medicare-approved suppliers must accept assignment, so you will never owe more than your 20 percent share.

Medicare usually covers one or two pairs per month. If your doctor prescribes more than that, Medicare may deny the additional pairs unless your doctor provides documentation that you need them.

Medicare Advantage and Medigap coverage

If you have a Medicare Advantage plan (Part C), compression stockings may be covered under the same rules as Original Medicare, but the copay or coinsurance amount may be different. Some Medicare Advantage plans cover compression stockings with no cost to you, while others charge a copay. Check your plan's formulary or call the plan's customer service number on the back of your card to find out what you will owe.

If you have a Medigap plan, it will pay your 20 percent coinsurance after Medicare pays its share, so your out-of-pocket cost is zero. Medigap does not cover the Part B deductible, so you still need to meet that first.

What to do if Medicare denies your claim

If Medicare denies your compression stocking prescription, the supplier will send you a notice called an "Explanation of Benefits" that explains why. Common reasons for denial include: the doctor's documentation does not clearly show a medical need, the compression level is not standard, or the quantity exceeds what Medicare considers reasonable.

You have the right to ask Medicare to reconsider. This is called an appeal. The supplier can help you file the appeal, or you can contact Medicare directly at 1-800-MEDICARE. You have 120 days from the date on the denial notice to file. If you believe your doctor's prescription is medically necessary, ask your doctor to write a letter explaining why and send it with your appeal.

Frequently Asked Questions

Can I buy compression socks at a drugstore and have Medicare pay me back?

No. Medicare only covers compression stockings ordered through a Medicare-approved supplier with a doctor's prescription. Buying them yourself at a store or online, even if they are the same brand and compression level, does not may have access to for coverage.

Do I need a referral to see a doctor about compression stockings?

Not usually. You can ask your primary care doctor or any doctor you see regularly about compression stockings. If your doctor thinks you need to see a specialist such as a vascular surgeon or dermatologist, they can refer you. Medicare covers the specialist visit if it is medically necessary.

How long does it take to receive compression stockings after I get a prescription?

Once your doctor writes the prescription and you give it to a Medicare-approved supplier, the supplier submits it to Medicare for review. This usually takes one to two weeks. After Medicare approves it, the supplier ships the stockings to you, which typically takes another one to two weeks. The total time is usually three to four weeks.

What if my compression stockings wear out or get damaged?

Medicare covers replacement stockings if they are damaged or worn out before the expected lifespan. Tell your supplier what happened, and they can request a replacement from Medicare. You may need a new prescription from your doctor if enough time has passed since the original one.

Are there any compression socks that Medicare will not cover?

Medicare will not cover compression socks marketed as fashion items, athletic wear, or general wellness products, even if they have compression. The socks must be prescribed by a doctor for a specific medical condition and ordered through a Medicare-approved supplier.