Get Diabetic Shoes Through Medicare: How to Know If You Qualify: Premier Podiatry: Velimir Petkov, DPM: Podiatrists (2024)

FAQs

How do you qualify for diabetic shoes? ›

The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts. A podiatrist (foot doctor) or other qualified doctor must prescribe the shoes or inserts, and you must get the shoes or inserts from one of these: A podiatrist.

The specific conditions covered by Medicare include severe foot disease and diabetes. Orthotics are covered under Part B. Technically, orthotics are considered part of the durable medical equipment (DME) bracket, including: Bracing for ankle, foot, knee, back, neck, spine, hand, wrist, and elbow.

Diabetic Shoes are considered durable medical equipment (DME) and require a prescription from your provider. You can call your insurance provider and ask about your benefits for diabetic shoes. Alternatively, our patient care coordinator Beata can help you out with a complimentary benefits check.

A doctor or other qualified individual (like a pedorthist, orthotist, or prosthetist) must fit and provide the shoes. Medicare Part B covers the furnishing and fitting of either one pair of custom-molded shoes and inserts or one pair of extra-depth shoes each calendar year.

If you require an orthopedic shoe, it must be prescribed by an authorized health care professional and fitted by an authorized provider. The authorized provider will have the necessary expertise to assess your needs, select the best shoe, and ensure that it fits correctly.

Medicare provides coverage for extra-depth shoes, custom-molded shoes, and shoe inserts for people with diabetes who qualify under Medicare Part B.

Custom foot orthotics are covered by Medicare Part B if ordered for you by a physician or nurse practitioner for a specific medical condition. Your healthcare and the orthotic supplier must participate in the Medicare program for your orthotics to be covered.

Medicare will only cover your orthopedic shoes if your doctors and suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren't enrolled, Medicare won't pay the claims they submit.

Do diabetics get free foot care? ›

Everyone with diabetes should have an annual foot check.

Your foot check is part of your annual review, which means you should have it as part of your diabetes care and it's free on the NHS. This is because you're more likely to have serious foot problems and these can lead to amputations.

Doctors prescribe them after surgeries to ensure proper healing. They also prescribe them as treatment for chronic conditions like arthritis, or for injuries such as whiplash. Medicare Part B pays for 80 percent of the approved cost of either custom-made or pre-made orthotic devices.

Most Medicaid enrollees receive insulin for free or at a significantly reduced cost. However, each state makes its own determination about which diabetes medications and supplies are covered through its Medicaid program.

What you'll usually see for diabetic shoes is a range of $50-200 per pair.

Yes, diabetic shoes can help reduce the pain associated with neuropathy. The skin has superficial nerves that ill-fitting shoes can easily aggravate, says Dr. Patel. He notes that diabetic shoes can help ease these irritations by offering increased depth, support, accommodation, and functionality.

Medicare pays only for therapeutic footwear from Medicare-approved suppliers, reimbursing 80% of the cost either to the patient or after the Part B deductible is met. The patient is responsible for the other 20% -- or more if the supplier does not "accept assignment" from Medicare.

Diabetic shoes decrease the risk of diabetic foot ulcers and thereby reduce amputations. They provide support and protection while minimizing pressure points on the feet. They also have extra depth to accommodate diabetic inserts. There are many styles to choose from, and the shoes look much like any other shoe.

Diabetic shoe provides a spacious toe-box to offer extra room for the toes—especially important when considering deformities such as bunions or hammertoes. They also often have extra depth to accommodate custom orthotic inserts, providing even greater support and distribution of weight away from pressure points.