Wellcare CalViva Health Dual Align (HMO D-SNP): Prosthetic Devices and Related Supplies

Prosthetics replace or restore lost functionality and include everything from orthotic shoes to implants to artificial limbs.

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Cost
$0 copay for Medicare-covered
Prior Authorization Required
Yes, for orthotics and prosthetics but not medical supplies
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  • $0 copay for Medicare-covered prosthetic or orthotics.

  • $0 copay for Medicare-covered medical supplies related to prosthetic devices.


Obtain an order from a primary care provider or other specialist for a prosthetic device.

  • This may take place in the course of existing treatment, such as with a cardiologist for heart arrhythmia.


Devices (other than dental) that replace all or part of a body part or function. These include but are not limited to testing, fitting, or training in the use of prosthetic and orthotic devices; as well as: colostomy bags and supplies directly related to colostomy care, pacemakers, braces, prosthetic shoes, artificial limbs, and breast prostheses (including a surgical brassiere after a mastectomy). Includes certain supplies related to prosthetic and orthotic devices, and repair and/or replacement of prosthetic and orthotic devices. Also includes some coverage following cataract removal or cataract surgery

Availability
Ongoing, and as needed for repair or replacement
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Prosthetic devices are devices (other than dental) that replace all or part of a body part or its function. For example, a pacemaker replaces the electrical signals in the heart, orthotic shoes replace structures in the feet that are missing or damaged, and a colostomy replaces part of the bowel.

Prosthetics and Orthotics

Also included are certain supplies related to prosthetic devices and repair and/or replacement of prosthetic devices. There may also be some coverage following cataract removal or cataract surgery (see Vision Care benefit). 

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