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Medically Modern

Orthotics & Bracing

Orthopedic Braces & Supports in New York

Ask us about your benefits first - under Medicare a brace must meet the orthosis benefit definition and the item-specific medical-necessity and coding requirements; we work from your practitioner's order to the correct code and confirm what your plan covers before you order.

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A few quick questions. No obligation.

  • Ask us about benefits first
  • Ask us what paperwork your plan requires
  • Ask us about delivery coverage
  • Ask us about refills
Hinged knee brace, lumbar back brace and CAM walking boot with a physician's order

What we offer

Braces, supports and mastectomy products - ask us about your benefits

  • Bracing & supports
  • Walking boots
  • Post-mastectomy products

  • Orthopedic Braces & Supports (Back, Knee, Ankle-Foot, Wrist & Cervical)

    Lumbar supports, hinged and unloader knee braces, AFOs, wrist splints, and cervical collars for arthritis, injury, post-surgical recovery, and neurologic conditions.

  • Immobilizers (CAM Boots, Slings)

    CAM walker boots, shoulder slings, and immobilizers for fractures, sprains, and post-operative protection.

  • Mastectomy Bras, Forms & Camisoles

    Post-mastectomy bras, external breast forms, and camisoles, matched to your surgery and your payer's allowance - ask us about quantities and replacement intervals.

Coverage explained

How brace coverage and documentation works

Want the detailed Medicare rules?

Under Medicare, a brace must meet the orthosis benefit definition, generally a rigid or semi-rigid device used to support a weak or deformed body part or to restrict motion, and also satisfy the item-specific medical-necessity and coding requirements for the code being billed. Mastectomy products follow separate authority: the Women's Health and Cancer Rights Act applies to certain group and individual coverage that provides mastectomy benefits, while Medicare separately covers qualifying external breast prostheses under its prosthetic-device benefit.

  1. 01Get the order
  2. 02Verify benefits
  3. 03Complete documentation
  4. 04Arrange delivery
  1. 1

    Practitioner order and benefit category

    The record must show the diagnosis, the joint or region involved, and that the ordered device meets the orthosis definition and the medical-necessity criteria for its code, not simply that a brace was requested.

  2. 2

    Correct product code and fit

    Ask us which billing code applies to the ordered brace. Ask us what documentation your plan requires, and ask the treating clinician to address any missing clinical elements based on their independent evaluation.

  3. 3

    Mastectomy product allowances

    Ask us about your payer's allowance for post-surgical bras and external breast prostheses, including quantities, replacement intervals, and eligibility dates.

  4. 4

    Replacement and repair

    Braces wear out. Ask us about your plan's replacement rules and, with your permission, ask your practitioner for a current order when one is required before reordering.

What patients typically pay

After the Part B deductible, you pay 20% of the Medicare-approved amount if your supplier accepts assignment. Ask us about your current benefits and your expected out-of-pocket cost. Benefit information is an estimate, not a guarantee of payment.

Want the specifics for your plan? Read how our insurance process works or check your coverage.

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More about how Medically Modern works

Ask us about coverage for orthotics & bracing first.

Medically Modern works with NY Medicaid, Medicare, and major insurance plans including Aetna, Humana, Fidelis, Anthem Blue Cross Blue Shield, NYSHIP Empire Plan, Cigna, MagnaCare, and UnitedHealthcare.

  • NY Medicaid
  • Medicare
  • Aetna
  • Humana
  • Fidelis
  • Anthem Blue Cross Blue Shield
  • NYSHIP Empire Plan
  • Cigna
  • MagnaCare
  • UnitedHealthcare
  • And more

Coverage depends on the specific plan, product, location, item, and benefit. Ask us to confirm that Medically Modern is eligible for your benefit before ordering.

Orthotics & Bracing FAQ

Brace and mastectomy product coverage questions

Official coverage sources

You can read payer rules here; ask us what your own plan allows.

Ask us whether Medicare Part B covers your knee orthosis. The device must meet the orthosis benefit definition and its item-specific medical-necessity criteria. Your practitioner documents the medical condition and the required examination findings; a diagnosis alone does not determine coverage.

Lumbar and lumbar-sacral orthoses are covered when the device meets the orthosis definition, the specific code's medical-necessity criteria are met, and the practitioner documents a qualifying spinal condition, not simply general back pain.

Be cautious with unsolicited brace offers; ask us before accepting anything billed under your number, and ask your own physician for any order.

Coverage for external breast prostheses and post-surgical bras varies by payer and plan. Separately, the Women's Health and Cancer Rights Act applies to certain group and individual coverage that provides mastectomy benefits. Ask us which authority applies to your coverage and what it allows.

Ask us about quantities, replacement intervals, and your eligibility dates under your payer's published allowance before ordering.

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Often, yes. If an order is delayed or denied, ask us about the next steps. Ask us what documentation your plan requires, and ask the treating clinician to address any missing clinical elements based on their independent evaluation. If an order is delayed or denied, ask us - we'll help you get the reason in writing from your plan.

See what your plan covers for orthotics & bracing

Start with a short form. Ask us about your coverage and item.

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