Medicare's Coverage of Compression Hose

Medicare Part B covers compression stockings and socks, but only when a doctor prescribes them for a medical reason — not for general comfort or prevention. The item must be prescribed by a physician, and you must meet specific medical criteria. Medicare will pay 80 percent of the approved amount after you meet your Part B deductible; you pay the remaining 20 percent.

The prescription must document a medical need such as lymphedema, venous insufficiency, or severe varicose veins. A doctor cannot prescribe compression hose straightforward because a patient wants them or because they might help prevent problems. The condition must be active and documented in your medical record before the prescription is written.

Key Takeaways

  • Medicare Part B covers compression stockings only when prescribed by a doctor for a diagnosed medical condition like lymphedema or venous insufficiency.
  • You must meet your Part B deductible before Medicare begins paying its 80 percent share; you pay 20 percent of the approved amount.
  • The prescription must come from your physician and include the medical reason, the type of compression needed, and how long you will wear them.
  • You can purchase from any supplier, but using a Medicare-enrolled supplier ensures the price falls within Medicare's approved amount.
  • Replacement stockings are covered once per year if your condition remains active and your doctor continues the prescription.

What Medical Conditions may have access to

Medicare recognizes compression hose as medically necessary for conditions that affect blood flow in the legs. The most common may have access to diagnoses are lymphedema (swelling caused by lymph fluid buildup), chronic venous insufficiency (when leg veins cannot pump blood back to the heart effectively), and severe varicose veins that cause symptoms like pain or swelling.

Your doctor must document that the condition exists and that compression therapy is the appropriate treatment. The prescription should state the compression level needed (measured in millimeters of mercury, or mmHg) and whether you need knee-high, thigh-high, or full-length stockings. Medicare will not cover compression hose for prevention alone, even if you have risk factors like a family history of blood clots or a job that requires long periods of standing.

How to Get a Prescription and Order

Start by talking to your doctor about whether compression hose would help your condition. If your doctor agrees, ask them to write a prescription that includes the medical diagnosis, the compression level (usually 15–20 mmHg for mild compression or 20–30 mmHg for moderate), and the type of stocking needed. Your doctor will submit this to Medicare or give it to you to take to a supplier.

Once you have the prescription, contact a Medicare-enrolled supplier in your area. You can search for suppliers on Medicare.gov or ask your doctor for a recommendation. The supplier will verify that your prescription meets Medicare's requirements and that you have met your Part B deductible. They will then send the stockings to you and bill Medicare directly for their 80 percent share.

What You Pay Out of Pocket

Your out-of-pocket cost depends on whether you have met your Part B deductible for the year. If you have not yet met it, you pay the full cost of the stockings until the deductible is satisfied. Once the deductible is met, you pay 20 percent of Medicare's approved amount for the stockings.

The approved amount varies by supplier and region but typically ranges from $40 to $100 per pair for standard compression stockings. If you use a supplier who is not enrolled in Medicare, you may pay more because their charges could exceed Medicare's approved amount. Always confirm the supplier is Medicare-enrolled before ordering to avoid surprise bills.

Replacement and Ongoing Coverage

Medicare covers one pair of compression stockings per year if your condition remains active and your doctor continues the prescription. If you need a replacement before 12 months have passed — for example, because the stockings wore out or no longer fit — you will need a new prescription from your doctor explaining why the replacement is medically necessary.

Your doctor must also recertify your condition periodically. If you have not seen your doctor in a while, schedule an appointment before ordering replacements so your prescription is current. Some suppliers will contact your doctor directly to verify the prescription is still valid.

When Medicare Does Not Cover Compression Hose

Medicare will not pay for compression stockings ordered without a doctor's prescription, even if you have a diagnosed condition. You also cannot use Medicare coverage for compression hose if you are in a Medicare Advantage plan (Part C) unless your specific plan includes this benefit — coverage varies by plan, so check your plan documents or call the plan directly.

Compression socks marketed for athletic performance, travel comfort, or general wellness are never covered by Medicare, regardless of the compression level. If your doctor prescribes compression hose but does not document a may have access to medical condition in your chart, Medicare will deny the claim. In these cases, you would pay the full cost yourself.

Frequently Asked Questions

Can I buy compression stockings over the counter and have Medicare reimburse me?

No. Medicare only covers compression hose that are prescribed by a doctor and ordered through a Medicare-enrolled supplier. Over-the-counter purchases, even if they are the same product, are not covered. You must have a prescription and use an enrolled supplier for Medicare to pay.

What if my Medicare Advantage plan does not cover compression hose?

Coverage varies by plan. Contact your plan directly to ask whether compression stockings are covered and what the requirements are. Some plans cover them under the same rules as Original Medicare; others may have different rules or not cover them at all. Your plan's customer service number is on your insurance card.

Do I need a new prescription every time I order replacement stockings?

You need a new prescription if more than 12 months have passed since your last order or if your condition has changed. If you are ordering within 12 months and your condition has not changed, the supplier may be able to use your existing prescription. Always ask the supplier whether they need a new prescription before ordering.

Can my doctor prescribe compression hose to prevent blood clots after surgery?

Compression hose prescribed for short-term use when ready after surgery or hospitalization may be covered, but this is different from ongoing compression therapy for a chronic condition. Ask your surgeon or hospital whether they will provide the stockings during your recovery, as they are sometimes included in your hospital bill rather than billed to Medicare separately.

What compression level does Medicare cover?

Medicare covers compression stockings in the range typically prescribed for medical conditions, usually 15–30 mmHg. Your doctor will specify the compression level based on your condition. Very high compression levels (above 30 mmHg) may require special justification and are less commonly covered.