Does Medicare Cover Diabetic Shoes?
Yes, Original Medicare provides coverage for diabetic or therapeutic shoes and inserts. According to Medicare.gov, Medicare Part B covers one pair of custom molded shoes with inserts or one pair of extra-depth shoes per calendar year for individuals with diabetes and severe diabetic foot disease.
Medicare also covers two extra pairs of inserts for custom-molded shoes and three extra pairs of inserts for extra-depth shoes annually. Medicare also covers shoe modifications instead of inserts.
How Much Does Medicare Pay For Diabetic Shoes?
Medicare will pay 80% of therapeutic shoes and inserts if you meet the eligibility criteria. You will need to pay the remaining 20% unless you have a secondary insurance plan like a Medicare Supplement plan that can cover all or some of the costs.
How Do I Qualify for Diabetic Shoes?
To qualify for diabetic shoe coverage with Medicare, you must have diabetes and have at least one of the following foot issues:
- Nerve damage in both feet (i.e., peripheral neuropathy or diabetic neuropathy) leading to loss of sensation or muscle weakness
- Foot deformities, such as hammertoes, bunions, or Charcot Foott that require therapeutic shoes or inserts
- Previous foot ulcerations that have healed or are currently being treated
If you meet these requirements, your doctor can prescribe diabetic shoes, and Medicare will cover 80% of the cost. Your doctor will have to certify that, without diabetic shoes, you are at risk of developing foot problems.
Which Types of Shoes Are Covered?
Medicare covers specific types of shoes, including depth-inlay shoes, custom-molded shoes, and extra-depth shoes. All the approved shoes provide more space to accommodate custom orthotics or inserts, and they come with supportive soles and breathable fabric to prevent foot issues.
Where Can I Buy Diabetic Shoes?
You cannot buy diabetic shoes from just any store. Medicare-approved suppliers provide diabetic shoes, and these suppliers must meet specific requirements to qualify. You can find a list of approved suppliers on Medicare’s website or by contacting your state health department. Buying shoes from an authorized supplier is best to be eligible for coverage.
How Much Do Diabetic Shoes Cost?
The cost of diabetic shoes varies depending on the manufacturer, type of shoes, and any additional features required. On the low end, they can cost around $150; on the high end, they can cost up to $500. However, your out-of-pocket costs will only be the portion left after Medicare pays its 80% portion.
Also, the amount you pay depends on several factors:
- Which Medicare health plan type you have (such as a Medigap or Medicare Advantage plan)
- The type of shoes you need
- The state in which you purchase them
- What facility you’re buying from
Medicare covers diabetic shoes and inserts for individuals with diabetes who have specific foot issues or are at risk of developing them. The coverage includes custom-molded shoes, depth-inlay shoes, extra-depth shoes, and shoe modifications.
Medicare Part B covers one pair of custom molded shoes with inserts or one pair of extra-depth shoes per calendar year. Medicare also covers two extra pairs of inserts for custom-molded shoes and three extra pairs of inserts for extra-depth shoes annually. Medicare also pays for modifications instead of inserts.
Medicare pays 80% of the cost, while the remaining 20% is your responsibility unless you have secondary insurance. You must buy the approved shoes from an authorized supplier. Be sure to speak with your doctor or healthcare provider if you have any questions about Medicare benefits for diabetic shoes.
What is the difference between orthopedic shoes and diabetic shoes?
Orthopedic shoes provide cushioning and support to help prevent or reduce foot pain. Diabetic shoes are designed to accommodate orthotics and inserts to protect the feet from diabetes-related problems such as neuropathy, ulcers, and deformities.
Why are diabetic shoes expensive?
Diabetic shoes are expensive because they have additional features, such as extra width and depth, to accommodate custom inserts or orthotics. The cost also depends on the type of material used, the style of the shoe, and other factors.
Do I need a prescription for diabetic shoes?
Yes, you must have a valid prescription from your doctor before buying diabetic shoes covered by Medicare. The prescription must certify that you need the shoes to prevent or reduce complications related to diabetes.