VNS Health prosthetics and orthotics coverage
We handle the paperwork. You focus on recovery.
VNS Health covers custom prosthetics and orthotics—and Orthotics Ltd manages the entire insurance process from start to finish. Prescriptions. Prior authorization. Claims. We take care of it so you can focus on getting back on your feet.
What VNS Health covers
Prosthetic devices
VNS Health covers medically necessary prosthetic devices, including:
- Lower limb prosthetics (below knee, above knee, partial foot, hip disarticulation)
- Upper limb prosthetics (below elbow, above elbow, partial hand, shoulder disarticulation)
- Bionic and myoelectric prosthetics (when medically necessary)
- Prosthetic socket replacements and adjustments
- Cosmetic covers and sleeves
Orthotic devices
VNS Health covers custom orthotic devices, including:
- Custom braces (ankle, knee, wrist, elbow, back, neck)
- Compression garments
- Spinal orthotics
- Custom-molded shoes and inserts
- Orthotic repairs and adjustments
Additional covered services
- Initial consultation and evaluation
- Custom fitting and adjustments
- Follow-up care and modifications
- Repairs and replacements (when medically necessary)
How VNS Health coverage works
Understanding VNS Health plan types
VNS Health (Visiting Nurse Service of New York) offers multiple health plan types in New York:
- VNS Health Medicare Advantage (HMO and HMO-POS plans)
- VNS Health Dual Advantage (Medicare and Medicaid)
- VNS Health Medicaid Managed Care
Coverage and cost-sharing vary by plan type. We’ll verify your specific benefits.
01
Get a prescription
Your physician provides a prescription for the prosthetic or orthotic device. We can help coordinate with your doctor's office if needed.
02
We verify your benefits
We contact VNS Health to verify your coverage and confirm what you'll owe out-of-pocket based on your plan type.
03
We submit prior authorization
VNS Health requires prior authorization for prosthetics and orthotics. We handle all documentation and follow up with VNS Health's review team.
04
We create your custom device
Once approved, we scan or cast your limb, create a test socket or device, and work with you until the fit is perfect.
05
We bill VNS Health directly
After delivery, we submit claims directly to VNS Health. You'll receive an Explanation of Benefits showing what VNS paid and any remaining balance.
What you'll pay with VNS Health
Medicare Advantage members
VNS Health Medicare Advantage members pay according to Medicare Part B guidelines:
Medicare Part B deductible (if not yet met)
20% coinsurance after deductible
Some VNS Health Medicare plans offer enhanced benefits with lower cost-sharing.
Dual Advantage members (Medicare and Medicaid)
If you have VNS Health Dual Advantage, you may have little to no out-of-pocket costs. Medicaid often covers Medicare cost-sharing.
Medicaid Managed Care members
If you have VNS Health through New York Medicaid, prosthetics and orthotics are covered with no copays, deductibles, or out-of-pocket costs.
We tell you what to expect upfront
Before we begin fabrication, we'll provide a clear estimate of your financial responsibility. No surprises.
Why Orthotics Ltd makes VNS Health coverage easy
We verify benefits before you commit
You'll know exactly what VNS Health covers and what you'll owe before we start creating your device.
We handle all prior authorizations
We submit all documentation to VNS Health and follow up until authorization is approved.
We bill VNS Health directly
You don't submit claims. We handle all billing and follow up with VNS Health on your behalf.
We work with your doctor
We coordinate with your physician's office to ensure we have all necessary prescriptions and medical documentation.
Home visits available
If getting to our clinic is difficult, we come to you. We offer home visits throughout the New York area.
Helpful VNS Health resources
Log in to check your benefits, view claims, and access your health information.
Search for in-network providers (Orthotics Ltd is in-network with VNS Health).
Contact VNS Health with questions about your plan or benefits. Customer Service: 1-855-VNS-CHOICE (1-855-867-2464)
Learn about Medicare Part B coverage for prosthetics and orthotics.
Information for Medicaid members.
Common questions about VNS Health coverage
Does VNS Health cover prosthetics and orthotics?
Yes. VNS Health covers medically necessary prosthetic and orthotic devices across all plan types.
Do I need a referral?
Most VNS Health plans are HMOs and require referrals from your primary care physician. We’ll verify this when we check your benefits.
How long does VNS Health authorization take?
Prior authorization typically takes 5-10 business days. We follow up with VNS Health throughout the process.
What if my prosthetic needs repairs?
VNS Health covers medically necessary repairs and adjustments.
Does VNS Health cover bionic or myoelectric prosthetics?
Yes, when medically necessary and prescribed by your physician.
Can you come to my home?
Yes. We offer home visits for patients who can’t travel to our clinic.
Do you work with nursing homes?
Yes. We partner with nursing homes throughout New York to provide prosthetic and orthotic services.
I have Medicaid through VNS Health. Will I owe anything?
Most Medicaid members have no out-of-pocket costs for medically necessary prosthetics and orthotics.
Locations serving VNS Health members
Orthotics Ltd serves VNS Health members throughout New York.
Our clinic:
Harriman, NY
We also offer:
- Home visits for patients who can’t travel
- Nursing home partnerships
- Emergency prosthetic services
Ready to use your VNS Health benefits?
