How Medicare Covers Lymphedema Treatment and Compression Therapy

December 4, 2025
How Medicare Covers Lymphedema Treatment and Compression Therapy

Introduction

Lymphedema—a chronic swelling in the arms or legs, often after surgery, cancer, or vascular damage—can complicate daily activities and lead to long-term discomfort or infection if not properly managed. With the passage of the Lymphedema Treatment Act, Medicare has taken major strides in providing expanded support for patients. If you or a loved one manage lymphedema, here is what to know about your coverage for diagnosis, specialist visits, compression therapy, and the latest medical supplies, as well as planning your ongoing care.

Lymphedema Treatment Benefits Under Medicare

Historically, Medicare was slow to provide broad lymphedema coverage beyond limited therapy visits. Today’s benefits address clinical needs more holistically:

  • Physical and occupational therapy: Medicare Part B pays for therapy needed to retrain the affected limb, maintain range of motion, drain excess fluid using specialized massage (manual lymphatic drainage), and develop home management or exercise plans.
  • Medical equipment and supplies: New Medicare provisions now offer coverage for physician-prescribed, FDA-approved compression garments, bandages, specialized sleeves and gloves, and sometimes electrical pumps designed explicitly for lymphedema.
  • Specialist consults: Office visits to lymphedema trained physicians, rehabilitation medicine, vascular surgery, and regularly reviewed nurse check-ins—billed and covered as any standard specialist service under Part B, subject to deductibles and coinsurance.

Your treating provider coordinates approval for these supplies and confirms their ongoing necessity to continue claims approval each calendar year or each therapy episode.

Coverage for Compression Garments The New Standard

Thanks to updates after the Lymphedema Treatment Act, Medicare now covers MOST doctor-ordered compression supplies to all qualifying beneficiaries:

  • This may include ready-to-wear or custom-fit sleeves, gloves, wraps, and short-stretch bandages ordered after evaluation by your custom-fitter or trained lymphedema therapist.
  • Physician documentation must show active lymphedema linked to surgery, trauma, cancer, or demonstrated lymphatic dysfunction warranting compression support.
  • Covered supplies are provided through Medicare approved suppliers (for equipment), and the member pays only standard deductibles and 20% coinsurance, making relief accessible throughout the year.

The number and replacement frequency of items (when items wear out from regular use or misplacement) is determined by your prescription and care plan—as tools to aid a medically challenging disease, not traditional comfort clothing.

Optimizing Your Access and Reducing Risk

  • Consult frequently with your lymphedema therapist and primary care team to update your prescribed compression levels or garment needs as clinical priorities shift.
  • Document sudden changes such as rapid swelling, new infections, or wound complications visible at extremity sites for immediate review with your doctor and Medicare case manager.
  • Request instruction at each therapy session about correct garment use, skin protection, and warnings for possible circulation problems or device misuse.
  • Check renewal dates for ongoing supply coverage and report any non-delivery or denied claims to your agent and therapy office quickly—a common hiccup if supplier paperwork is incomplete or out of date.
  • Leverage Medigap or Medicare Advantage for further assistance with coinsurance or equipment extras, as some plans offer more flexibility and streamlined readiness for at-home management.

Specialized Support for Lifelong Comfort

Lymphedema care no longer means living with unmanaged pain or unreliable aid. Expanded Medicare benefits ease the complexities of regular garment changes and reduce infection risks or lost function through routine therapist reviews. For any questions about claims, provider approval, or your custom plan for advanced supplies, contact Vista Mutual Insurance Services. Our knowledgeable team will act as your advocates—ensuring you receive continuous, effective lymphedema support tailored to every phase of the journey.