Does Medicare Cover Shoes for Diabetics?
Foot injuries can happen to virtually anyone, and if you suffer from mobility issues, you may be more prone to foot injuries than others; however, there are also plenty of conditions like poor circulation, diabetes and congenital defects that can affect the feet and cause pain and difficulty getting around. To address these concerns, you may require medications or even surgery, but many orthopedic problems can be treated first with custom shoes and/or inserts.
Medicare Benefits Solutions
Oct 16, 2020
3 minutes read
How do orthopedic shoes and inserts help?
Orthopedic shoes and inserts, often referred to simply as orthotics, can be used to correct foot conditions in some patients, while in others, these medical devices can be used to alleviate symptoms enough to allow for normal mobility. This may be true for individuals who are facing diabetes, but orthotics will typically be used in combination with medications and lifestyle adjustments.
Does Medicare cover shoes for diabetics?
Original Medicare insurance typically covers shoes for diabetics under Part B; however, there are some restrictions. Medicare coverage recipients who require shoes for diabetic conditions will usually be able to receive one pair of custom-molded shoes and inserts and/or one pair of extra-depth shoes per calendar year. Additionally, Medicare will cover two pairs of inserts for custom-molded shoes and three pairs of inserts for extra-depth shoes on top of the inserts that come with the original shoes. If you require new shoes or more inserts within the calendar year, you will likely have to cover the cost on your own.
How much of the cost does Medicare cover?
Like with other medical equipment covered under Medicare Part B, diabetic shoes and inserts are generally covered for 80% of the cost. This leaves you to cover the remaining 20%. Covered diabetic shoes and inserts will also need to be purchased from a Medicare-approved provider. If you purchase shoes or inserts on your own from a non-approved footwear retailer, you will be responsible for 100% of the cost.
Although Medicare Part B is the primary coverage source for diabetic shoes and inserts, you might run into a situation in which custom shoes and inserts are required during a stay at a skilled nursing facility or hospital. If the shoes and inserts are provided by the facility, Medicare Part A may apply coverage instead of Part B. Medicare coverage provided under Part A is the inpatient benefit and covers the cost of services rendered while admitted to a medical facility for care.
Since Medicare Part D covers prescription drugs, it would not directly apply to coverage for diabetic shoes. Part D may apply if you are prescribed medications to treat diabetes in addition to the prescription of diabetic shoes and inserts.
Does Medicare Advantage plans cover diabetic shoes and inserts?
If you have a Medicare Advantage plan, you already receive the same coverage offered by Original Medicare, as Medicare Advantage plans are required to offer this coverage at a minimum. You may, however, be entitled to additional benefits through your plan provider since many Medicare Advantage plans provide extra coverage for recipients. Some plans may include additional pairs of shoes and/or inserts at a discount or you may be able to purchase diabetic shoes from a wider network of providers. To learn more, you will need to speak directly with a representative from your Medicare Advantage plan administration office.
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