07/23/2025
Myth‑Buster: “Over‑the‑counter braces are covered like custom ones.”
🚫 Myth:
"If I buy an off-the-shelf brace and get it from my DME supplier, insurance will treat it the same as a custom-fitted orthopedic brace."
✅ Fact:
Insurance coverage differs depending on the type of brace:
- OTC braces are often not covered or only covered when custom-fitted by a specialist—despite being physically identical
- Custom-fitted braces require a healthcare provider's prescription, proof of medical necessity, and fitting by a qualified orthotist
Not every brace is covered equally. Even identical braces can be treated differently by insurers.
✔ Prescription + proper fitting + prior auth = best chances for coverage.
