Does Medicare Pay for Diabetic Shoes? | Benefits, Types & How to Get Reimbursed

Introduction

Diabetes is a serious medical condition that affects millions of people around the world. People with diabetes are at an increased risk of developing foot problems due to poor circulation and nerve damage. Diabetic shoes can help reduce the risk of injury and improve mobility, but many people wonder if Medicare covers the cost of these shoes. In this article, we will explore the answer to this question and provide information on the types of diabetic shoes covered by Medicare, eligibility requirements, and tips for maximizing your coverage.

Overview of Medicare Coverage for Diabetic Shoes

Medicare does cover some types of diabetic shoes, but it is important to understand what is and is not covered before making a purchase. Medicare Part B (Medical Insurance) covers medically necessary therapeutic shoes or inserts prescribed by a doctor for people with diabetes. The shoes must meet certain criteria in order to be eligible for coverage. Medicare does not cover routine foot care, such as cutting toenails, treating calluses, or other general foot care services.

How to Determine if You are Eligible

In order to be eligible for Medicare coverage of diabetic shoes, you must have one of the following conditions: peripheral neuropathy, Charcot’s foot deformity, history of foot ulcerations, or a high-risk foot condition. Your doctor must also certify that the shoes are medically necessary and that they meet the criteria set forth by Medicare. Your doctor will need to fill out a special form called the “Certificate of Medical Necessity” which must be submitted along with your claim.

Benefits of Wearing Diabetic Shoes

Wearing diabetic shoes can provide many benefits, including improved mobility, better blood flow, and reduced risk of injury. These shoes can help reduce pressure points on the feet and provide cushioning and arch support. They can also help protect against cuts, bruises, and blisters. Additionally, wearing diabetic shoes can help keep your feet dry and comfortable.

Types of Diabetic Shoes Covered by Medicare

Medicare covers three types of diabetic shoes: orthopedic shoes, therapeutic shoes, and custom-made shoes. Orthopedic shoes are designed to provide extra support and cushioning for the feet. Therapeutic shoes are designed to reduce the risk of injury due to foot deformities or other conditions. Custom-made shoes are made specifically for the individual and provide the most support and comfort.

How to Get Reimbursed for Diabetic Shoes Through Medicare

In order to get reimbursed for diabetic shoes through Medicare, you must submit a claim with the appropriate documentation. This includes the “Certificate of Medical Necessity” form filled out by your doctor, a copy of your prescription, and a copy of the itemized bill from the supplier. It is important to note that Medicare only covers up to 80% of the approved amount, so you may be responsible for the remaining 20%.

What to Consider When Choosing the Right Diabetic Shoes

When choosing the right diabetic shoes, it is important to consider comfort, fit, and style. Make sure the shoes fit properly and that they provide adequate arch and heel support. The shoes should also be comfortable to wear for extended periods of time. Finally, choose a style that appeals to you and matches your personal preferences.

Tips for Maximizing Medicare Coverage for Diabetic Shoes

There are several ways to maximize your coverage for diabetic shoes. You should shop around to compare prices and look for discounts or promotions. Additionally, you can ask your doctor for assistance in selecting the right shoes and filing the necessary paperwork. Finally, make sure to submit all required documentation with your claim to ensure timely reimbursement.

Common Questions About Medicare Coverage for Diabetic Shoes

People often have questions about Medicare coverage for diabetic shoes. Here are some of the most common questions:

• What does Medicare cover? Medicare covers medically necessary therapeutic shoes or inserts prescribed by a doctor for people with diabetes.
• What is not covered? Medicare does not cover routine foot care, such as cutting toenails, treating calluses, or other general foot care services.
• How do I file a claim? You must submit a claim with the appropriate documentation, including the “Certificate of Medical Necessity” form filled out by your doctor, a copy of your prescription, and a copy of the itemized bill from the supplier.

Conclusion

Diabetic shoes can provide numerous benefits to those with diabetes, including improved mobility, better blood flow, and reduced risk of injury. Medicare does cover some types of diabetic shoes, but it is important to understand what is and is not covered before making a purchase. To maximize your coverage, shop around and ask your doctor for assistance. For more information on Medicare coverage for diabetic shoes, visit the Centers for Medicare & Medicaid Services website.