Does Medicare Cover Podiatry?

Medicare Benefits Solutions

Aug 5, 2020

As we age, healthy feet are vital to staying active, improving balance and preventing falls. According to the American Podiatric Medical Association (APMA), seniors often require hospitalization following fall injuries, which underscores the importance of keeping feet healthy and wearing proper footwear. 

APMA also states that “most Americans log an amazing 75,000 miles on their feet by the time they reach age 50,” and that half of all Americans claim to have had foot pain at one time or another during their lives. Podiatrists are specialists in the diagnosis and treatment of foot and ankle disorders, and Medicare Part B covers their services under certain conditions.  

Part B Medicare Benefits

Part B Medicare benefits can be expected if you suffer from nerve damage related to diabetes. Diabetes patients are eligible for Medicare coverage of foot exams on a semi-annual basis, contingent upon a diagnosis of diabetic peripheral neuropathy and a lack of protective sensations. However, if for any other reason you visited your foot care practitioner in between these visits, the coverage for the six-month exams would not apply.  

Some medically necessary foot treatments unrelated to diabetes may be allowed. For example, if you have a foot injury or disease, such as a deformed bunion, hammer toe or heel spurs, the cost of treatment would fall under Part B as well.

Out-of-pocket Expenses

Routine foot care falls outside of Medicare benefits. Examples of routine foot care are corn and callus removal, nail trimming and clipping, and feet cleaning and soaking. When foot exams and treatment are covered, you are responsible for 20% of the Medicare-approved charges after meeting the Part B deductible. The 2020 annual deductible is $198. If treatment is provided in a hospital outpatient facility, the copayment to the hospital is your responsibility in addition to the out-of-pocket expense for the doctor’s services. 

Your Feet Deserve Care

The APMA offers the following suggestions to keep your feet in tiptop condition:

• Use moisturizer to prevent the skin around your feet from becoming dry and cracked.
• Practice a stretching regimen to avoid toe cramps, relax feet and loosen joints.
• Indulge in a foot massage to improve circulation and revitalize skin.
• Make sure pedicures are done properly with the right tools.
• Elevate swollen feet and ankles by raising legs above your heart.
• For day-to-day activities, don comfortable shoes that offer proper arch support and padding on the sole.
• See a podiatrist if your feet hurt continuously. 

Medicare Advantage Coverage for Podiatry

If you’re enrolled in a Medicare Advantage plan, you’ll have at least the same Part A and Part B coverage as Original Medicare, but many plans include additional benefits. Check with your plan to find out if any additional podiatry services are included in your coverage package.