What's Covered? Who's Covered? After the Lymphedema Treatment Act

According to the guidelines available on the Lymphedema Treatment Act website, Medicare will provide coverage for various garments and supplies used in treating lymphedema. This coverage includes:

Items Covered:

• Garments:

  • Custom and standard-fit garments for daytime and nighttime use.

  • Gradient compression wraps with adjustable straps, both custom and standard fit.

• Bandaging Supplies:

  • Includes all necessary supplies for any phase of treatment, with no limits specified.

• Accessories:

  • This category covers a broad range of items necessary for the effective management of lymphedema, including but not limited to donning and doffing aids, padding, fillers, linings, and zippers.

Frequency of Coverage:

• Daytime Garments:

  • Patients are entitled to three sets (one garment per affected body part) every six months. This can include a combination of standard or custom-fit garments.

• Nighttime Garments:

  • Two sets (one garment per affected body part) are covered every two years, available in standard or custom fit.

• Bandaging Supplies:

  • There is no set limit on the number of bandaging supplies covered.

• Accessories:

  • Coverage for accessories is determined on a case-by-case basis, depending on the patient's specific needs.

Eligibility Requirements:

• Coverage is available to patients diagnosed with lymphedema and hold a prescription with supporting clinical notes for the necessary compression supplies.

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