What Are Diabetic Shoes?
This article was updated on: 09/15/2018
People with diabetes sometimes develop problems with their feet, according to the Centers for Disease Control (CDC). Medicare may cover therapeutic shoes for diabetics (sometimes called diabetic shoes) with severe diabetic foot disease.
Why are diabetic shoes important?
Diabetics may suffer from diabetic neuropathy. This type of nerve damage may make feet vulnerable to injuries in a few different ways, according to the National Institutes of Health:
- Injuries may take longer to heal because of restricted blood flow.
- Affected limbs may lose sensation, so it’s more difficult to detect an injury and get it treated promptly.
- If you lose feeling in your feet, an unnoticed injury can lead to an infection.
The Centers for Disease Control (CDC) suggests quarterly foot exams for diabetics. In addition, the agency recommends a good regimen of home care. This includes keeping feet clean, inspecting feet for injuries, keeping toenails carefully trimmed, and wearing the right socks and shoes.
In addition to neuropathy, complications associated with diabetes may even change the shape of the patient’s foot and weaken the muscles. The National Institute of Health, or NIH, recommends checking with a doctor about special diabetic shoes and/or shoe inserts. In some cases, diabetics may need custom-made shoes to provide extra protection.
Medicare coverage for diabetic shoes
Medicare Part B may cover therapeutic shoes, or diabetic shoes. In order for diabetic shoes to qualify for coverage, a podiatrist or another kind of qualified doctor has to prescribe them. Additionally, a podiatrist, prosthetist, orthotist, pedorthist, or other qualified type of professional has to provide the therapeutic shoes.
Part B has some limits to its coverage of diabetic shoes:
- Part B may cover one pair of extra-depth or custom-molded, diabetic shoeswith inserts each year.
- For custom-molded shoes, Part B may cover up to two pairs of inserts each year.
- For extra-depth shoes, Part B may cover up to three pairs of inserts each year.
- Medicare may cover shoe modifications instead of inserts in some situations.
If the medical provider accepts Medicare assignment, you pay 20% with Original Medicare. The Medicare Part B deductible also applies to diabetic shoes.
You will want to make sure your Medicare supplier accepts Medicare assignment, so you can avoid paying more than the Medicare-approved amount.
How do Medicare health plans cover diabetic shoes?
Medicare Advantage plans, available from private, Medicare-approved insurance companies, must cover everything that Original Medicare (Part A and Part B) cover except for hospice care, which Part A covers. So if you have a Medicare Advantage plan, it should cover diabetic shoes as described above if the conditions are met.
If you don’t have a Medicare Advantage plan, you may be able to enroll in a Medicare Supplement (Medigap) plan to help pay for Original Medicare’s out-of-pocket costs. Different Medigap plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles.
If you need help understanding how your current plan covers diabetic shoes, and you’re enrolled in a Medicare Advantage plan or a Medicare Supplement plan, you may want to call your insurance company. You can also contact Medicare 24 hours a day and seven days a week: 1-800-Medicare or 1-877-486-2048 for TTY.
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