Employer/Self-employed Health Plans

Some employer and self-employed health plans may provide coverage for crutches. Be sure to check your specific plan details to see if you are eligible.

Medicare-Medicaid Coverage (CMS HCPCS Codes)

Medicare and Medicaid may also cover crutches under certain circumstances. The following HCPCS codes are relevant:

• E0110: Crutches, forearm (includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips)
• E0153: Platform attachment, forearm crutch (each)

FSA/HSA/DLA Distinctions

You may also be able to use funds from your Flexible Spending Account (FSA), Health Savings Account (HSA), or Dependent Care FSA (DCFSA) to pay for crutches. Here are some key differences between these accounts:

FSA

• • A Flexible Spending Account (FSA) allows you to set aside pre-tax money to cover eligible out-of-pocket health care costs.
  • You contribute to your FSA on a pre-tax basis, which means you save money on taxes.
  • You must use your FSA funds by the end of the plan year or you will forfeit them.

HSA

• • Like an FSA, an HSA allows you to set aside pre-tax money to cover eligible health care costs.
  • You can only have an HSA if you have a high-deductible health plan (HDHP).
  • HSA funds roll over from year to year, so you don’t have to worry about losing them.
  • You can use your HSA funds to cover a wider range of expenses than an FSA, including qualified medical expenses, dental and vision expenses, and long-term care premiums.

DLA

• • A Dependent Care FSA (DCFSA) allows you to set aside pre-tax money to cover the cost of dependent care, such as childcare or eldercare.
  • You can only use your DCFSA funds to cover the cost of care for dependents who are under the age of 13 or who are incapable of self-care.

Doctor’s Prescription

In most cases, you will need a doctor’s prescription to get your insurance to cover the cost of crutches. The prescription should include the following information:

• The diagnosis or reason why you need the crutches
• The type of crutches you need (e.g., forearm crutches, underarm crutches)
• The phrase “medically necessary” should be included on the Rx

Note that this is not an exhaustive list, and your doctor may need to include additional information depending on your specific situation.