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.
Medicare Part B (medical insurance) provides coverage for either of the following items, once per calendar year:
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.
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:
Wearing these therapeutic shoes can help people with diabetes improve the circulation in their feet while also helping keep them more comfortable.
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):
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.
And many Medicare Advantage plans provide coverage for healthier food options and memberships to SilverSneakers gyms for exercise.
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