Does Medicare Cover Diabetic Shoes?

Medicare does cover diabetic shoes or inserts for qualified beneficiaries.

Diabetes can cause nerve damage and lower the amount of blood flow to the feet. This can lead to problems like ulcers and gangrene in the foot, which can in turn lead to amputation of toes and other lower extremities.

One way of helping to reduce the effects of diabetes on the feet is by wearing special therapeutic shoes. In this guide, we detail how Medicare covers diabetic shoes and other diabetes treatments.

Man tying his shoe on a park bench ready to jog

Will Medicare pay for diabetic shoes?

Medicare Part B (medical insurance) provides coverage for either of the following items, once per calendar year:

  • One pair of extra-depth shoes and three sets of inserts

  • One pair of custom-molded shoes and inserts, and two additional sets of inserts

Medicare will also cover shoe modifications in lieu of inserts.

In order to qualify for coverage, you must have diabetes and severe diabetic foot disease. A doctor must certify your need for diabetic shoes and prescribe them for use.

As long as your prescribing doctor and the supplier of your diabetic shoes accepts Medicare assignment, you’ll be responsible for 20 percent of the Medicare-approved amount for the cost of the shoes (after you meet your Part B deductible, which is $198 per year in 2020).

If your doctor or supplier does not accept assignment, they may charge you up to 15 percent more than the Medicare-approved amount for the therapeutic shoes. This cost is known as an “excess charge.”

If your doctor or supplier do not participate in Medicare, the shoes will not be covered by Medicare, and there is no limit to what you may be charged.

What are the benefits of diabetic shoes?

Diabetic shoes provide extra protection for your feet and help guard against blisters, ulcers, infections and other problems that can arise when nerves and blood flow are compromised.

Some typical features of diabetic shoes include:

  • A higher toe area to allow room for hammertoes
  • Little to no stitching that can lead to a cut or irritation
  • A padded collar around the ankle to help with swelling
  • A protected exterior around the toes to prevent stubbing
  • Custom fitting to the length and width of your feet
  • A special insole that reduces the back-and-forth rubbing that can cause blisters

Wearing these therapeutic shoes can help people with diabetes improve the circulation in their feet while also helping keep them more comfortable.

Does Medicare cover diabetes treatment and supplies?

Diabetic shoes are far from the only diabetes treatment devices that are covered by Medicare. The list of additional diabetes services and items covered by Medicare includes (but is not limited to):

  • Diabetes screenings
  • Blood sugar monitors and continuous glucose monitors
  • Blood sugar test strips
  • Lancets and lancet devices
  • Insulin
  • Diabetes self-management training
  • Nutrition therapy services
  • Eye exams for diabetic retinopathy

In 2018, Medicare expanded the Medicare Diabetes Prevention Program (MDPP), which is a partnership between Medicare and private organizations to provide education and lifestyle changes to people at risk of type 2 diabetes.

A Medicare Part D prescription drug plan or a Medicare Advantage plan that includes prescription drug coverage can also help provide coverage for your diabetes medications.

And many Medicare Advantage plans provide coverage for healthier food options and memberships to SilverSneakers gyms for exercise.

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