Does Insurance Pay for Crutches? Medicare, Medicaid and Private Plan Coverage Explained

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Most private health plans, Medicare, and Medicaid classify crutches as durable medical equipment (DME), which means reimbursement may be available. Whether your plan pays, how much it pays, and what paperwork you need depends on the specific plan and situation. The general path is consistent: get a prescription, confirm your benefit before buying, use a qualified supplier, and submit a claim.

Not a guarantee of coverage. Coverage varies by plan and situation. Confirm details with your provider and plan.

Does Private Health Insurance Pay for Crutches?

Most employer group plans, marketplace plans, and individual policies include a DME benefit. That benefit may pay for crutches when a few conditions are met:

• Prescription: Most plans require a written order from a licensed provider before processing a DME claim.
• Network: Using a DME supplier that participates in your plan’s network typically means a higher reimbursement rate. Out-of-network purchases may still qualify at a reduced rate.
• Deductible status: If your annual deductible has not been met, you may owe the full purchase price before the plan’s contribution applies.
• Prior authorization: Some plans require approval before you purchase crutches as DME. Ask before buying.

The billing code payers use to identify forearm crutches is HCPCS E0110 (“crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips”). Providing this code when you call member services or work with a supplier helps ensure the claim is routed and categorized correctly.

If your plan is through Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, or another major carrier, check the DME benefit section of your Summary of Benefits and Coverage (SBC) document, or call member services and ask specifically about HCPCS E0110.

How Medicare May Pay for Crutches (Part B DME)

Medicare Part B includes a DME benefit, and forearm crutches fall under HCPCS code E0110. Here is how reimbursement generally works under traditional Medicare:

1. Doctor’s order: Your treating physician must be enrolled in Medicare and provide a written order for crutches.
2. Enrolled supplier: The DME supplier must also be enrolled with Medicare. Purchasing from a non-enrolled supplier means Medicare will not process the claim.
3. Deductible and coinsurance: Medicare Part B has an annual deductible. Once it is met, Medicare typically pays 80% of the approved amount; you pay the remaining 20%. A Medigap supplement may cover part of your share, depending on your plan.
4. Assignment: Suppliers who accept assignment agree to Medicare’s approved amount as the full charge. Suppliers who do not accept assignment can charge up to 15% above the approved amount.

Medicare Advantage plans (Part C) must provide at least the same DME benefits as traditional Medicare, but they may have different prior authorization rules and their own supplier networks. Check with your specific Advantage plan before buying.

Call 1-800-MEDICARE or visit medicare.gov to confirm the DME coverage details that apply to your specific situation.

Medicaid Coverage for Crutches

Medicaid is a joint federal-state program, and each state sets its own DME benefit rules. Coverage for crutches varies by state. In many states, crutches are an eligible DME item for qualifying members when prescribed by a participating provider.

To find out whether your state Medicaid plan may pay for crutches:

1. Contact your state Medicaid agency or managed care organization directly.
2. Ask whether HCPCS E0110 is included in the state DME benefit.
3. Ask whether prior authorization is required and how long the process typically takes.
4. Ask whether there is a preferred or required supplier network.

If you are enrolled in both Medicare and Medicaid (dual-eligible), Medicare Part B is typically the primary payer for DME. Your Medicaid plan may then pay some or all of the remaining cost-sharing. Confirm this arrangement with both programs before purchasing.

VA Coverage: Veterans and TRICARE

Veterans enrolled in VA healthcare may receive crutches through the VA’s prosthetics and sensory aids benefit. The VA process typically runs through a VA prescriber and the VA prosthetics department rather than through a commercial DME claim. TRICARE plans (for active-duty service members, retirees, and their families) follow their own DME benefit rules, which differ from commercial plans.

For a detailed walkthrough of how VA and Medicare reimbursement paths work and what questions to ask, see our VA and Medicare crutch coverage guide.

Can I Use FSA or HSA Funds for Crutches?

In most cases, yes. Crutches are generally considered durable medical equipment, which makes them typically FSA-eligible and often HSA-eligible under standard IRS guidelines. Paying with a Flexible Spending Account or Health Savings Account lets you use pre-tax dollars, which reduces your effective out-of-pocket cost even when your health plan does not contribute anything.

To use FSA or HSA funds: confirm with your plan administrator that the specific product qualifies, pay with your benefits card or reimburse yourself after purchase, and keep your itemized receipt. For a full breakdown of how FSA and HSA payments work for crutches, see our FSA and HSA crutch eligibility guide.

How to Get Crutches Through Insurance

The general process is the same across most payers:

Step 1: Get a prescription. Ask your doctor for a written order that includes HCPCS code E0110. This is the standard billing code for forearm crutches and is recognized by Medicare, Medicaid, and most private plans.

Step 2: Confirm your coverage. Call your plan’s member services line and ask:

• Is HCPCS E0110 in my DME benefit?
• Do I need prior authorization?
• What is my deductible and coinsurance for DME?
• Do I need to use an in-network supplier?

Step 3: Purchase from a qualified supplier. Use an in-network DME supplier when your plan requires or prefers it. If you buy online or at a pharmacy, request an itemized receipt with the product name, purchase date, and HCPCS code.

Step 4: Submit your claim. If the supplier bills your plan directly, they handle submission. If you paid out of pocket, download a claim form from your plan’s member portal, attach your prescription copy and itemized receipt, and submit for reimbursement. Keep copies until the claim is resolved.

For Medicare and Medicaid specifically, step 2 should also confirm that both your doctor and the DME supplier are enrolled with the program.

Not a guarantee of coverage. Coverage varies by plan and situation. Confirm details with your provider and plan.

Comparing crutch options while you sort out your insurance situation? See our best forearm crutches comparison for the top-scored picks, or take the quiz to find the right model for your recovery.