Diabetic Shoes and Medicare Coverage: Inserts and Shoes for Diabetics Covered by Medicare
If you have diabetes, you know that foot care is important. You also know that diabetic shoes and inserts can help prevent serious complications.
What you might not know is that Medicare will cover some of the cost of these items.
In this blog post, we’ll explain how diabetic shoes and inserts are covered by Medicare and what you need to do to get coverage.
Table of Contents
What are Diabetic Shoes?
Diabetic shoes are shoes that are designed to provide extra comfort and support for people with diabetes. Diabetes can cause problems with the feet, including neuropathy (nerve damage), which can lead to pain, ulcers, and infections.
How to get cost-effective and Therapeutic Footwear
There are many places to buy diabetic shoes, including from your podiatrist or other medical supply carriers. Diabetic shoes must be fitted by a board-certified pedorthist, podiatrist, orthotist, or doctor before they are supplied. Be sure the supplier you choose accepts Medicare, to ensure Medicare will pay the claims for your DME.
How much does Therapeutic Footwear Cost?
There are many factors that affect the cost of diabetic shoes, from insurance to the type of facility you visit. However, there are ways to get cost-effective diabetic shoes that still provide the necessary support and comfort. Here are a few tips:
- Check with your insurance company to see if they cover diabetic shoes. Many insurance companies will cover at least part of the cost of these specialty shoes.
- Shop around for the best prices on diabetic shoes. You can often find good deals online or at local retailers.
- Ask your doctor for a prescription for therapeutic footwear. This type of shoe is often covered by Medicare and other insurance plans.
- For those enrolled in Medicare, you may qualify for specialized shoes or inserts at no cost if you have the Medigap Plan F.
- Veterans enrolled in the Veteran Administration healthcare system who need therapeutic shoes may qualify for no-cost DME supplies.
What is the Therapeutic Shoe Bill (TSB)?
The Therapeutic Shoe Bill is a bill that was passed in 1993 to help people with diabetes get the therapeutic shoes they need to be covered by Medicare. In order to be eligible for reimbursement, there are certain requirements that must be met. These requirements are detailed in the bill itself.
Does Medicare Pay for Diabetic Shoes?
Diabetic shoes are specially designed to provide comfort and support for people with diabetes. They can help prevent foot problems and ulcers, and improve blood circulation.
Yes, Medicare will cover one pair of diabetic shoes per year for diabetic patients with a severe diabetic foot. Medicare patients will need to talk with their doctor so they can write up the needed prescription.
Medicare Beneficiaries may be responsible for their Part B deductible depending on the plan they are enrolled in. Other out-of-pocket expenses may include a 20 percent coinsurance or a copay if enrolled in a Medicare Advantage plan.
Where can I buy Medicare-Approved Diabetic Shoes to Protect my Feet?
You can buy them at any retail store that sells shoes or online. However, Medicare won’t pay the claim from a store that is not a Medicare-approved supplier.
Medicare coverage of therapeutic footwear must be purchased from a durable medical equipment supplier that accepts assignment.
What are the benefits of Medicare-Approved Diabetic Shoes?
The benefits of Medicare-Approved Diabetic Shoes are that they are custom-molded and have inserts that help to provide support and cushioning for your feet. They also help to prevent foot ulcers and amputations.
How can I get Help with Medicare Coverage for Diabetic Shoes?
If you meet certain criteria for diabetic footwear, Medicare allows one pair of extra-depth shoes per calendar year. Your treating physician will assist in qualifying for diabetic prescription shoes.
Do Medicare Advantage Plans Help Cover Orthopedic Shoes?
Medicare Advantage plans are a type of health insurance that helps cover the costs of diabetic shoes including molded shoes and extra-depth shoes.
You must still meet all the eligibility requirements for Medicare Advantage plans, including having a doctor who is part of the plan’s network.
To find the right Medicare plan for you, we can help by providing you with all available Medicare plans in your area.
Can Medigap Coverage Pay the Cost of Therapeutic Shoes?
Yes, many Medicare Beneficiaries participate in Medicare Supplemental plans as they provide tremendous health insurance benefits. These plans help contain medical costs and allow older adults to easily budget their health care costs.
One of the most popular Medicare Supplement plans is the Medigap Plan G.
With this plan, Medicare Beneficiaries’ only cost is their annual Medicare Part B deductible. Once the deductible has been paid, all other healthcare services are covered at 100 percent.
For example, if you paid your annual Part B deductible at the beginning of the year for doctor’s visits and now need an extra depth shoe to treat your foot deformity, your out-of-pocket cost would be zero.
Do you have questions about the differences between a Medicare Advantage plan and a Medigap plan? Give one of our Medicare Agents a call.
Which Medicare Part Covers Diabetic Shoes Covered?
Medicare Part B generally covers diabetic shoes and inserts, but if you purchase them from a non-approved retailer, you will be responsible for 100% of the cost.
Medicare Part A may cover diabetic shoes and inserts if provided by a skilled nursing facility or hospital. However, Medicare Part D does not cover diabetic shoes.
Those with a Medicare Advantage plan may not like this answer as your plan may charge a 20 percent coinsurance for this benefit. Your zero-dollar copay for doctor’s visits may not apply to this benefit.
If you are prescribed medication to treat diabetes, Part D may apply.
Integrity Now Insurance Brokers can help you find out if your existing plan covers podiatry services.
What Diabetic Shoes Will Medicare Cover?
If you have diabetes, you may be wondering what type of diabetic shoes can you buy. The great news is you qualify for shoes and three pairs of inserts.
Your shoe options have only increased in availability and styles. This means you are no longer stuck with an unattractive pair of shoes.
There are both stylish shoes for men and women available for purchase.
How Often Will Medicare Cover New Diabetic Shoes?
If you suffer from diabetic neuropathy and have a medically necessary need for diabetic footwear you may qualify for shoe inserts and therapeutic footwear. Original Medicare provides coverage for one pair of extra-depth shoes and one pair of custom-molded shoes per calendar year.
You can obtain these shoes and inserts each calendar year from a durable medical equipment supplier that accepts Medicare assignment.
Medicare also covers two additional pairs of inserts for custom-molded shoes and 3 pairs of inserts each calendar year for extra-depth shoes. If you would rather have a shoe modification instead of an insert Medicare also provides coverage for this.
Need Medicare Coverage that Includes Top-Notch Part B Benefits
Integrity Now Insurance Brokers is here to help you get the additional benefits you deserve. Our team of Medicare experts will help you navigate your health plan options so you can secure a Medicare plan that won’t make you go broke.
One pair of shoes should not break the bank and we are here to help you enroll in a plan that is best for your medical needs.
Call us today and talk with one of our Medicare Supplement Insurance Agents or one of our Medicare Advantage Insurance Agents to reduce or eliminate your DME costs. We can be reached at 562-735-3553 or simply fill out our Medicare quote request form.