Therapeutic shoes & inserts

Medicare Part B (Medical Insurance)

 covers the furnishing and fitting of either of these each calendar year, if you have diabetes and severe diabetic foot disease:

  • One pair of custom-molded shoes and inserts
  • One pair of extra-depth shoes

Medicare also covers:

  • 2 additional pairs of inserts each calendar year for custom-molded shoes
  • 3 pairs of inserts each calendar year for extra-depth shoes

Medicare will cover shoe modifications instead of inserts.

Your costs in Original Medicare

After you meet the Part B deductible , you pay 20% of the Medicare-Approved Amount (if your supplier accepts assignment).

Medicare will only cover your therapeutic shoes if your doctors and suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren't enrolled, Medicare won't pay the claims they submit.

It's also important to ask your suppliers if they participate in Medicare before you get therapeutic shoes. If suppliers are participating suppliers in Medicare, they must accept assignment (which means they can charge you only the coinsurance and Part B deductible for the Medicare-approved amount). If suppliers aren't "participating" and don't accept assignment, there's no limit on the amount they can charge you.

Note:

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • If your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

Note:

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and if, or how much, Medicare will pay for them.

Things to know

The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts.

A podiatrist (foot doctor) or other qualified doctor must prescribe the shoes or inserts, and you must get the shoes or inserts from one of these:

  • A podiatrist
  • An orthotist
  • A prosthetist
  • A pedorthist
  • Another qualified individual