Medicare coverage for compression socks and stockings depends on several factors and conditions.
This article explains the use of compression socks and stockings, and looks at Medicare coverage and eligibility. It also discusses costs and suppliers.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Compression socks and stockings are designed to give consistent pressure on a person’s legs, which may help blood flow back toward their heart.
- Thromboembolism: Wearing compression socks and stockings can help promote blood circulation, which can decrease the amount of blood pooling in the legs to potentially avoid blood clots.
- Swelling: Compression socks and stockings can help reduce lower-leg swelling, which can be common in congestive heart failure. They may also prevent edema or the pooling of excess fluid in the lower legs.
- Diabetes: A person with diabetes may have lower extremity edema and affected circulation. According to Diabetes Research and Clinical Practice, mild compression stockings can decrease lower extremity edema without negatively affecting a person’s circulation.
- Orthostatic hypotension: This condition causes a person to feel faint if they stand up too quickly. The faint feeling is related to blood flow changes, which compression socks and stockings may help alleviate.
- Leg aching/tired legs: Leg aching or tiredness may be due to affected circulation in a person’s lower legs, and compression socks and stockings may help reduce these sensations.
- Venous stasis ulcers: These ulcers may be related to poor blood flow in the lower legs, and generally need wound care for treatment, which may include the use of compression socks and stockings to promote blood flow.
Are there different types of socks or stockings?
Compression socks and stockings vary depending on where the compression is concentrated and the strength of the compression. There are also specialty socks and stockings.
The variations include:
- Compression variation: Some socks and stockings have graduated compression, which means the compression is greatest at a person’s ankle and lessens as the compression goes towards the knee. Standard compression stockings and socks exert the same pressure throughout and may be labeled as having ‘uniform’ compression. A doctor or professional usually fits graduated compression stockings.
- Compression strength: Compression stockings are measured in the amounts of pressure or mmHg they exert. Examples of common measurements include 15–20 mmHg and 20–30 mmHg. Some stockings also offer ‘extra firm’ compression of 30–40 mmHg. Compression stockings of 40–50 mmHg are usually available only by prescription.
- Pneumatic compression: These are specialty compression stockings that wrap around the lower legs and use a special motor to squeeze a person’s legs intermittently to provide extra pressure. Hospitals most commonly use these compression types for surgical and post-surgical patients.
Compression legwear may also be constructed of different materials, where some feel more like hosiery (thin) while others are made of thicker sock material.
Medicare is federally regulated and has four parts.
- Part A pays for inpatient stays, such as at a hospital or inpatient rehabilitation facility.
- Part B medical coverage helps pay for doctor’s visits and medical expenses, such as durable medical equipment. Part B also covers some vaccines and injectable or intravenous medication infusions.
- Part C is also known as Medicare Advantage and is offered by private insurance companies. All plans must provide at least the same coverage as original Medicare (Part A and Part B), and may offer additional benefits.
- Part D is prescription drug coverage.
Coverage for compression socks and stockings
Original Medicare does not recognize compression socks/stockings as durable medical equipment (DME) and therefore does not provide coverage for the legwear.
However, some Medicare Advantage plans provide some coverage for over-the-counter medical expenses, which may include compression socks and stockings. A person can contact their Advantage plan provider to check coverage, and also ask the following questions to confirm reimbursement:
- Is there a price limit to the compression socks and stockings?
- What paperwork should I submit for reimbursement?
- Is there a limit to the number of compression stockings and socks I can purchase under this plan?
Sometimes, Medicare Part B may cover the costs for compression socks and stockings when they are directly related to treating a person’s venous stasis ulcer. Under these circumstances, Medicare may consider the compression socks as wound dressings.
For example, a doctor may dress a person’s leg ulcer with ointments and bandages. They may then prescribe the wearing of compression stockings as a means to keep the bandages in place and promote blood flow.
For Medicare to cover these costs, a doctor must usually write a prescription for the compression legwear or certify the stocking or sock is a wound dressing. A person cannot get compression socks or stockings and declare them as a wound dressing.
However, a person may still have out-of-pocket costs related to their Part B deductible or copays.
Compression socks or stockings vary in price based on the amount of pressure exerted, stockings and socks material, and their medical purpose.
For example, knee-high compression stockings range in price from $64– $228, according to the Lymphedema Advocacy Group.
Socks and stockings with mild to moderate compression (anywhere from 8–30 mmHg) can generally be found at most pharmacies, some shoe stores, and online stores and pharmacies.
A person will usually get prescription compression socks and stockings from a medical supply store. If the compression legwear is considered a wound dressing, a person will usually need to make sure the store accepts Medicare. The prescribing doctor will often recommend medical supply stores in a person’s area or online pharmacies that can supply the socks and stockings.
Compression socks and stockings may improve blood circulation and reduce the discomfort that comes with prolonged standing. Medicare will usually only cover the costs of these socks if a doctor prescribes them for wound treatments.
If a person has a Medicare Advantage plan that covers some over-the-counter expenses, they may cover costs. A person may also wish to reach out to community organizations, such as the United Way, local churches, or Goodwill donation centers to obtain free or low-cost socks or stockings.