Does Medicare Cover Ostomy Supplies?

Medicare covers ostomy supplies if you have a surgically created opening, or stoma, to divert urine or stool to outside your body.

These medically necessary supplies are covered by Medicare if you’ve undergone certain surgeries, including a colostomy, ileostomy or urinary ostomy.

You must have a prescription, signed and dated by your doctor, on file with the supplier who provides your ostomy materials.

You can order ostomy supplies from large mail-order distributors and local durable medical equipment suppliers.

You generally can’t get ostomy supplies from a local drugstore or retail pharmacy.

Ostomy supplies are covered by Medicare Part B as durable medical equipment. Specifically, these items are considered prosthetics because they replace a body organ or organ function.

You will owe 20% of the Medicare-approved amount for these supplies. Medicare pays the other 80%.

The Part B deductible — $257 in 2025 — also applies.

You may pay less for your ostomy supplies if you have supplemental insurance, such as Medicaid or a Medigap policy.

Medicare Advantage plans, which are administered by private insurers that contract with the federal government, must provide the same basic coverage as Original Medicare.

However, if you’re enrolled in a Medicare Advantage plan, there may be additional benefits or criteria you must follow to order your supplies.

Make sure to contact your Medicare Advantage plan’s customer service department to learn about such details before ordering your supplies.

The list of covered Medicare ostomy supplies is long.

The quantity and kind of supplies you need depends on the type of ostomy surgery you undergo.

The U.S. Centers for Medicare & Medicaid Services, or CMS, has determined standard quantities of ostomy supplies each beneficiary can receive.

Medicare may cover more items if your doctor clearly documents a need for additional supplies in your medical record.

Otherwise, Medicare may deny excess quantities If adequate documentation is not provided when requested.

The table below shows the maximum number of items typically considered medically necessary for certain common ostomy products. This is not an exhaustive list.

In some situations, Medicare may restrict coverage for the type of ostomy supplies you can order.

Getting the medically necessary ostomy products you need can be tricky unless you follow certain Medicare rules and procedures.

When you are being discharged from the hospital to your home following ostomy surgery, your doctor should send the prescription for your supplies to a supply distributor approved by Medicare.

This prescription will include your list of ostomy supplies, amount and manufacturer reference numbers.

Similarly, if you are discharged home with home care, the home health care agency should be provided with this information from your doctor.

Keep in mind that home care agencies reimbursed by Medicare often have ostomy supply costs bundled into the payment for home care.

If Medicare denies your claim for ostomy supplies, you can file an appeal.

It may be helpful to review the denial with a health care professional who’s familiar with ostomies prior to filing an appeal. He or she might be able to identify the problem and provide a solution.

You can also call Medicare at 1-800-633-4227 for more information about why your claim was denied, and if needed, assistance with filing an appeal.