Does Medicare cover Orthopedic Shoes?
This article was updated on: 10/06/2018
Why wear orthopedic shoes?
According to the Cleveland Clinic, the average person will walk the equivalent of four times around the earth in his lifetime. The circumference of the earth is 24,901 miles, so that’s almost 100,000 miles of walking. It may then be no surprise that the majority of people will experience foot and ankle problems at some point in their life. Some foot problems are genetic and some stem from wearing improper footwear, according to the Cleveland Clinic. According to the U.S. National Library of Medicine, custom-made orthopedic shoes are effective in reducing foot pain and foot pressure.
What am I looking for in orthopedic shoes?
According to the Mayo Clinic, when shopping for orthopedic shoes look for:
- Support and flexibility in the sole
- A large toe box
- A reasonable cushion that creates padding between your foot and the ground
Shoes that are too tight, too small and don’t give enough support can cause pain and other problems such as injuries and deformities.
Does Medicare cover orthopedic shoes?
Medicare coverage of orthopedic shoes is generally limited to people with diabetes and severe diabetic foot disease. Medicare Part B (medical insurance) may cover the fitting and purchase of either one pair of custom-molded orthopedic shoes and inserts each calendar year or one pair of extra-depth orthopedic shoes each calendar year. Medicare may also cover shoe modifications instead of inserts. In addition, Medicare may cover two additional pairs of inserts each calendar year for custom-molded shoes and three pairs of inserts each calendar year for extra-depth shoes. Even if you have diabetes, a doctor such as a podiatrist, must certify that you need orthopedic shoes or inserts. Further, your orthopedic shoes or inserts must be supplied by an orthotist, prosthetist, pedorthist or other qualified individual trained in treatment of the conditions of the foot and ankle.
If your supplier accepts Medicare assignment, you generally pay 20% of the Medicare-approved amount and the Medicare Part B deductible applies. Your doctors and suppliers also must be enrolled in Medicare for Medicare to provide coverage for your orthopedic shoes.
Medicare Advantage is another way to you get your Medicare Part A (hospital insurance) and Medicare Part B (benefits) in one plan offered by a private company. Medicare Advantage must cover everything that Original Medicare (Part A and Part B) covers with the exception of hospice care, which Medicare Part A still covers. Medicare Advantage plans often cover additional benefits, such as prescription drug coverage. To find out if a Medicare Advantage plan will cover orthopedic shoes even if you don’t have diabetes, contact the plan.
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