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Medicare Coverage for Diabetic Shoes


Medicare can provide coverage for shoes and inserts designed for people with diabetes. Medicare beneficiaries will have help covering the cost of their diabetic supplies as well as have reimbursement on diabetic shoes. We’ll discuss where you can buy your shoes, how much they cost, and more.

Does Medicare Pay for Diabetic Shoes?

Medicare can pay a portion of the cost of your diabetic shoes. Part B will cover both the fitting and the footwear.

Below, we’ll look at just what you can get if Medicare pays for your diabetic shoes.

  • One custom pair of molded shoes with inserts if you have either a severe diabetic foot condition or diabetes
  • One pair of extra-depth shoes
  • Two extra pairs of inserts every year for your customer-molded shoes
  • Three pairs of inserts every year for extra-depth shoes

Also, Medicare can cover the cost of modifications to your shoes, rather than inserts. For Medicare to cover your diabetic shoe cost, your doctor must verify that the shoes are medically necessary.

You need to meet at least three of these health conditions:

  • Diabetes
  • Foot deformity
  • Nerve damage caused by diabetes
  • Foot ulcers
  • Amputation of the foot
  • Poor circulation
  • Must be getting treatment through a thorough health care plan.

Medicare also requires:

  • Your doctor needs to verify the need for your therapeutic shoes.
  • You get a prescription from an authorized health care professional.

Remember that even with Medicare, you may still pay a portion of the bill. You could end up with copays, coinsurance, and deductible costs.

What Diabetic Shoes Will Medicare Cover?

Medicare allows one pair of extra-depth shoes per calendar year. Also, Medicare covers three pairs of inserts each calendar year. Medicare covers diabetic shoes and inserts. If the doctor or supplier submitting the claims doesn’t accept Medicare, then Medicare won’t pay the claims.

Where to Buy Medicare-approved Diabetic Shoes

When you’re ready for a pair of diabetic shoes, you’ll have plenty of options. You can buy the shoes from your podiatrist or other medical supply carriers. Another option is finding a supplier online. Your diabetic shoes need to be both fitted by a podiatrist or other doctor. Whoever prescribes diabetic shoes can also supply the shoes.

What is the Therapeutic Shoe Bill (TSB)?

Congress passed the TSB or diabetic shoe benefit a while back. Ever since the bill was passed, Part B provides reimbursement on therapeutic shoes, inserts, and modification for beneficiaries that have diabetes and meet specific eligibility requirements.

You might be eligible if you have diabetes, documentation from a qualified physician, and at least one of the following:

  • Amputation of all or part of either foot
  • Foot deformity
  • Poor blood circulation
  • History of ulcers
  • History of pre-ulcerative calluses
  • Diabetic neuropathy with evidence of callus formation

If you think you’re unsure about your eligibility, you can contact a Medicare representative.

How Much Do Diabetic Shoes Cost?

Diabetic shoes can be costly because they’re specialty shoes. Shoes will need to be customer-fitted for your feet.

Most diabetic shoes can range in cost from $50-$200 per pair.

Thankfully, Medicare does cover these shoes in most cases. But if you don’t have insurance, you could be paying these high costs yourself.

Medicare Reimbursement for Shoes

For Medicare to reimburse for the cost of shoes, you’ll need to visit only doctors and suppliers that take Medicare. If you end up visiting a doctor who doesn’t accept Medicare, you could end up footing the entire bill.

Do Medicare Advantage Plans Cover Diabetic Shoes?

Medicare Advantage policies can cover the costs of your therapeutic shoes. Since Medicare covers diabetic shoes, Medicare Advantage plans will also cover diabetic shoes. Of course, you must still meet all eligibility requirements. And keep in mind, Advantage plans have specific networks. If your particular doctor doesn’t fall into the network, you may not have coverage for your shoes and doctor.

Can Medigap Help Cover the Cost of Diabetic Shoes?

A Medigap policy may be just what you need to help cover your diabetic shoes. Medicare Supplement plans are a great asset in helping cover extra costs. And a Medigap policy can help cover the out of pocket expenses you may have when getting diabetic shoes. Be aware that different Medigap plans have different coverages, so you’ll want to be sure you have the best policy.

FAQs

Does Medicare cover shoes for diabetic neuropathy?
Medicare can cover extra-depth shoes for diabetic neuropathy. You can get one pair of extra-depth shoes, and three pairs of inserts.
How do I get free diabetic shoes?
Sometimes beneficiaries may qualify for diabetic inserts and shoes at no charge. You’ll need to have your doctor certify that the shoes are necessary for your health. And on top of that, you will also need to complete some critical documents. Once you and your doctor sign the forms, you can take the forms to specific suppliers to get shoes at no cost.
Can nurse practitioners prescribe diabetic shoes?
Nurse practitioners can prescribe diabetic shoes. Physician assistants, nurse specialists, and podiatrists can also prescribe these shoes. Doctors need to provide proper documentation that the patient’s feet have a thorough examination.
Are diabetic shoes considered Durable Medical Equipment?
Diabetic shoes will fall under Part B benefits, much like most Durable Medical Equipment.

How to Get Help with Medicare Coverage for Diabetic Shoes

If you have diabetes and need therapeutic shoes, your doctor can help get you started. And when you choose to buy Medigap coverage, you can take assurance that your shoes won’t cost you an arm and a leg.

Your Medigap plan can help with coinsurance, copays, and your Part B deductible. Our agents can help find the best options for you.

Call us today for a quote in minutes! Or, if you prefer, you can complete an online rate form, and a member of our team will reach out to you.

Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

20 thoughts on “Medicare Coverage for Diabetic Shoes

  1. Please explain Medicare therapeutic shoe policy for people with neuropathy and other qualifying findings but caused by a disease other than diabetes

      1. Hello. I have severe nerve damage in my right foot but I’m not diabetic. The only shoes I can wear cost $160. I’m on disability and I’m in debt from buying them on my credit card. Will medicare consider other diagnoses?

      2. Hi Yvette. At this time, Medicare will only cover them if you’re a diabetic. I would reach out to your healthcare provider directly to see if they have any other options for you.

  2. I have type 2 diabetes,my PvP sent me to a podiatrist because of diabetic neuropathy, the podiatrist confirmed the neuropathy and said I have developed hammer goes and need diabetic shoes that Medicare would pay for them and some replacement insoles ,now what do I do?

    1. Hi Samantha! Your doctor should be able to help you find a diabetic shoe manufacturer that accepts Medicare who can help you get the shoes you need.

  3. I have to have custom diabetic shoes because of a deformed foot. I have all the necessary forms filled out by the right doctors that I need. The place that is making my new shoes says medicare will pay 80% of the cost. My supplemental insurance will pay the other 20%. Now I am told that medicare pays only a certain dollar amount and stops even though it doesn’t meet the 80% leaving my bill at $380. Is this the right information or is the company making my shoes not filing the right papers through medicare?

    1. Hi Monty! Without seeing the itemized bill, it’s very difficult to say if it’s accurate or if the diabetic shoe company is billing incorrectly. The $380 could be a combination of many things, including the Part B deductible. Are you sure you have a Medigap plan vs Medicare Advantage? That could also be the issue here. I would call Medicare directly to find out for sure where these charges are coming from.

    1. Hi Frank! I believe the benefit is limited to one pair of shoes and up to 3 pairs of inserts or shoe modifications per calendar year.

      1. What is considered a calendar year? 1 year from the date they were dispensed? A fiscal calendar year? Or January through December?

  4. I’m in a situation my Prostedics are in need of replacement have had them for year my problem my healthcare system is in Rancho Cucamonga Ca. Coverage area is not in Kern County were I at and they don’t cover any of my Amputee needs never have. Reason I have open Ulcers on left stump. I am responsible for what Medicare does not pay. Not eligible for welfare or Medical and permanently on federal disability. Can I use Medicare to pay for housing and education?

    1. Hi Aaron! It sounds like you have a Medicare Advantage plan vs a Medicare Supplement plan. A Medicare Advantage plan provides less coverage than a Medigap plan would, especially in situations such as yours. If a Medigap plan does not fit into your budget, you may be eligible for a Medicare Savings Program. You may also be eligible for the Extra Help Program. Both of these programs will help you pay for the out of pocket costs that Medicare doesn’t cover.

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