Question
I hear Medicare helps cover diabetic shoes. Is this true?
— Caring.com Community Member, nuhusker95
Answer
Expert Joseph L. Matthews is a Caring.com senior editor, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and Social Security, Medicare, & Government Pensions: Get the Most Out of Your Retirement & Medical Benefits.
Yes, it's true. Medicare Part B?can pay for most of the cost of therapeutic shoes for someone whose diabetes has caused serious foot problems. If you have diabetes, Medicare can cover therapeutic shoes if you are being treated by a physician under a comprehensive diabetes care plan, and your doctor or podiatrist prescribes the shoes because you have either: a partial or complete amputation; a history of foot ulcers; calluses that can lead to ulcers; nerve damage that can lead to calluses; poor circulation; or a deformed foot.
If you meet these conditions, each year Medicare can cover one pair of depth-inlay shoes and three pairs of inserts, or one pair of custom-molded shoes and three pairs of inserts (if you can't wear depth-inlay shoes because of a deformity). The shoes have to be fitted and provided by a podiatrist or other doctor, or a licensed pedorthist, orthotist, or prosthetist who participates in Medicare.
If you meet the conditions, Medicare Part B will pay 80 percent of the Medicare-approved cost of the shoes (after you've paid your yearly Medicare Part B deductible of $135). You're responsible for the other 20 percent. Check to make sure that the provider of the shoes accepts Medicare assignment of the Medicare-approved amount as the full amount for the shoes. If not, the shoe provider could charge you much more than the Medicare-approved amount. If the provider doesn't accept assignment, shop around for another provider who does. To see Medicare's explanation of these rules, look at its special publication Medicare Coverage of Diabetes Supplies & Services.
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