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?
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:
- 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.
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.