What Medicare Covers for Diabetics Dealing with Chronic Pain

Living with diabetes often involves more than just a change in diet and regular glucose testing. Diabetic individuals in the United States often experience a wide variety of complications that have a significant impact on daily life. One of the most impactful (and frequently misunderstood) issues that many people deal with is chronic pain, often caused by neuropathy.

Those who are experiencing chronic pain with diabetes often have several questions: How do I manage these pain issues while still living my life to the fullest? What treatment options are available to me? What does Medicare or my insurance company cover to treat?

We are here to help clarify how people with diabetes can use their Medicare coverage to live their best lives when faced with chronic nerve pain.

Why is chronic pain common in people with diabetes?

Chronic pain is defined as moderate to severe pain that is felt on a daily basis and continues for over six months. Statistically, people with diabetes are more susceptible to long-term pain than those without the diagnosis. Not all nerve pain has the same root cause, however. Here are some of the reasons a person with diabetes may be dealing with this issue:

  • Neuropathy. This is a common complication of diabetes that can include pain and numbness in the back, feet or hands.
  • Arthritis. Type 2 diabetes and arthritis both disproportionately affect people who are older, making the combination fairly common among aging Americans.
  • Fibromyalgia and pain conditions. While these conditions may not be directly linked to diabetes, chronic pain disorders combined with diabetic neuropathy can exacerbate the challenges people face.

What can I do to manage my chronic pain with diabetes?

Prescription medications are often the first thing discussed when it comes to treating chronic pain, but many different and non-drug treatment options can  help support an effective treatment plan. Luckily, Medicare covers many of these things.

For a full list of items covered by Medicare for people with diabetes, click here.

1) Use a Transcutaneous Electrical Nerve Stimulator (TENS Therapy)

freedom tens unit covered by medicare for diabetes chronic painTENS therapy uses small electrical impulses to block pain signals and increase endorphins. It is recommended by many pain management professionals as a non-invasive, non-painful and non-surgical way to treat neuropathy and similar conditions.

Besides its effectiveness, this treatment is used by many people with chronic pain because it is easy to do from the comfort of  home. The FREEDOM TENS Unit is a device that people can keep on hand to respond to pain flare-ups. It comes with four modes (Burst, Normal, Pulse Width Modulation, Pulse Rate Modulation) allow users to modify the treatment depending on what works for them.

How to get it a TENS unit covered by Medicare: Talk to your doctor to get a signed “durable medical equipment” prescription for a TENS unit. You will need to meet certain standards in order to be approved for coverage, including the verifying that the pain is chronic (3 months or longer). Medicare will typically cover a 30 to 60 day rental of the unit to start, then allow people to move onto a full purchase if the treatment is successful. For more information on the paperwork needed and how to rent or buy a TENS unit, contact Quantum Medical Supply at 1-866-923-2423.

2) Wear the right shoes and inserts.

If you are feeling chronic pain in your feet, ankles, legs or even hips, there is some relief available: Medicare covers one pair of therapeutic shoes and three pairs of inserts for qualifying people each year. Even if the pain has not reached your feet, diabetic shoes can play an important role in protecting from future damage.

How to get diabetic shoes and inserts covered by Medicare: To obtain coverage, your doctor will need to fill out both a Certificate of Medical Necessity and a Shoe Prescription. The shoe prescription can also come from a podiatrist or nurse practitioner. Your shoes will also need to be professionally fitted and ordered your shoes from a Medicare-approved supplier. Some, like nocostshoes.com, are even able to directly bill your insurance company. To see if you qualify, click here to fill out our application.

3) Get back, knee, ankle and/or wrist braces.

Braces are commonly recommended by doctors and physiotherapists to reduce pain from free-moving joints. There are specific types of braces that may be more beneficial for long-term use by someone with chronic pain; for example, this product from TemCare Pro uses an air pump system to help people customize the compression for added comfort.

How to get diabetic shoes and inserts covered by Medicare: Like shoe coverage, a certificate of medical necessity and qualifying diagnosis is needed to get coverage for these items. For more details on what is available and the documents needed for coverage, call 866-923-2423.

4) Control your blood sugar using a continuous glucose monitor (CGM).

Managing blood sugar should be at the top of your list if you’re dealing with any symptoms of diabetes, including chronic pain from neuropathy. Medicare covers various blood sugar/glucose testing aids including test strips, syringes, and insulin pumps. One of the most exciting and often lesser known things Medicare covers for glucose management is a continuous glucose monitor or CGM.

Continuous glucose monitors like the Dexcom G6 are an easy-to-use alternative to a finger prick blood sugar test. Using a small sensor placed below the skin, it keeps an eye on glucose on an ongoing basis. This can improve the accuracy of readings and remove the discomfort of a traditional test. Best of all, this technology is free or deeply subsidized for people with Medicare and certain insurance plans!


What is the difference between diabetic shoes and “regular” shoes or sneakers?

There is a good reason Medicare covers a pair of diabetic shoes each year for qualified people in the United States. The risk of serious complications, up to and including loss of limbs, is very real for people with diabetes. Foot care is a must for this segment of the population, and diabetic shoes are among of the most important preventative tools available. Despite this fact, many people are still unsure whether they need diabetic shoes. What makes these therapeutic shoes different from every day, “regular” sneakers, anyway?

First, let’s clarify the basic differences – if you look closely, you’ll see there are many! Here are some of the characteristics of therapeutic shoes for people with diabetes:

First, let’s clarify the basic differences – if you look closely, you’ll see there are many! Here are some of the characteristics of therepeutic shoes for people with diabetes:

Increased depth for insoles/orthotics: Diabetic shoes have significantly more depth. This added space can accommodate orthotics or insoles (3 pairs of therepautic inserts are also covered by Medicare each year).

wide diabetic shoes sneakers

Smooth interior for blister prevention: People with diabetes are extremely prone to blisters and ulcers, so these shoes take no chances. Stitching will only be found on the outside of the shoe, while the inside remains completely smooth.

Heel counter to keep the foot in place: A heel counter is a plastic insert that reinforces the heel cup of a shoe. These are built into diabetic shoes to keep the foot in place and increase stability.

Padding for stability: Padding will be found around the collar of the ankle and the tongue of the shoe. Like the heel counter, this helps keep the foot secured in place and prevents twisted ankles and other missteps.

Increased space and protection for toe health: Unlike other shoes which aretoe box diabetic shoes for women tight around the toes, these shoes offer more space in the toebox. This is a particularly helpful feature for those with conditions like hammertoes. The toebox also has added protection, so stubbing your toe will be less of a risk to your foot health.

Non-skid soles and proper fitting to prevent falls: Twisting an ankle, tripping over feet or falling over can cause particular issues for people with diabetes, especially those who have nerve damage or pre-existing foot conditions. The stable design of these shoes, professional custom fittings, and no-slip soles can help keep wearers safe and secure.

Diabetic insoles to prevent movement within the shoe: Blisters and other injuries are often caused by an unsecured foot moving back and forth within a shoe. Multi-density diabetic insoles are a critical part of diabetic shoes (that’s why Medicare covers 3 per year!) as they help to prevent this issue.

Can people without diabetes wear these shoes?

Non-diabetics purchasing and wearing therapeutic shoes is actually fairly common! They are extremely comfortable and effective in preventing ulcers, blisters, and other issues, so feet of all kinds can find refuge in a pair.

The most inexpensive way to purchase diabetic shoes if you are not covered by Medicare is to go to an insurance-approved supplier like No Cost Shoes. While No Cost Shoes is mainly used by people approved for direct billing to insurance, it also offers the option to purchase shoes at a lower rate than most storefronts because of its wide inventory.

Can I just wear comfortable sneakers if I have diabetic neuropathy or related issues?

As you can see from the above comparison, there are major differences between even the most comfortable pair of sneakers and properly fitted diabetic shoes. Why take the risk, especially when you can get shoes completely for free through insurance and Medicare? Not only are diabetic shoes the healthier and safer option, but for many Americans, they are less costly as well.

What about special occassions or formal work meetings? Women in particular can sometimes feel pressured to take a risk with their health and wear a strappy pair of heels for “just one night.” The problem with this is that all it takes is one tiny blister to set off a chain reaction that ends with an ulcer and even a lost limb for someone with diabetes. It is a better idea to shop for some attractive therapeutic shoes that will match the occasion, such as the popular Mary Janes from Apex or the “Breeze” and “Paradise” lines from Dr. Comfort. You can find several different styles, colors and options on NoCostShoes.com.
fashion diabetic shoes brown slip on orthofeet
Orthofeet Slip-On w/ Strap Brown
apex mary jane diabetic shoes for women
Janice Black Velcro shoes from APEX
diabetic shoes for going out special occassion women
Paradise Pewter Velcro Shoes from Dr. Comfort




Tips for Managing and Living with Diabetic Neuropathy

Neuropathy, also known as “nerve damage,” is an uncomfortable condition common in people with diabetes. People with neuropathy experience weakness, numbness and pain in their hands and feet. The symptoms of neuropathy can have a real impact on daily life, from sleeping to driving and beyond.

Here are some of our top tips for managing and living with diabetic neuropathy.

Note: This article is a collection of general, helpful tips and should not replace professional medical advice. Talk to your doctor about any treatment techniques when dealing with neuropathy.

What to do when you can’t sleep because of  neuropathy at night

Restless woman Insomnia neuropathy diabetes

For some people, neuropathic pain worsens at night. The reasons neuropathy may feel worse in the later hours include:

  • Lack of distractions, putting more focus on the pain in your hands and feet;
  • Change in temperature, sending confusing messages to the neuropathic nervous system; and
  • Physical and emotional stress from the day.

The best way to manage neuropathic pain at night is to calm the mind, care for the body and control the temperature.

Those who are having trouble sleeping because of neuropathy should try visualizing something positive and non-stressful, like a dream vacation or an upcoming celebration, and focus on that thought rather than the pain. Meditation and music can also help to move a person’s mind from issues with their feet and hands. Additionally, they may want to add some blankets to your bed to keep your body warm. Do not use heating pads or hot water to warm numb or painful feet. People with neuropathy have trouble gauging temperature and can get burns or blisters when they use hot water in this way.

Neuropathic pain at night can also be combatted by changing behavior during the day. For example, people can take a short walk to clear their head each day (as long as their doctors clear them to put weight on their feet). Similarly, they can try alternating physical routines so no day is particularly strenuous.

Is it possible to drive with neuropathy?

driving with neuropathy how to

With some support, many people with nerve damage are able to drive.

First, let’s understand why driving is a challenge for people with neuropathy. One of the main symptoms of neuropathy is foot numbness. When a driver can’t feel their feet, it can be difficult or impossible to drive safely. Think about it: Without functional nerves, how would you sense where the brake pedal is? How would you know how much pressure you are putting on the gas?

Luckily, there are alternative technologies that can help people with this condition to drive without using their feet to control the brakes and the gas. This is the process for most drivers:

  • Purchasing and installing car hand controls;
  • Working with a driver rehabilitation specialist to “relearn” how to drive with these new controls; and
  • Passing a special needs licensing exam if required by your state.

These controls aren’t always cheap, so it is a good idea for people with neuropathy to look into coverage of adaptive equipment from Medicare or other insurance. These products and services are often covered for qualifying people in the United States.

Is it safe to walk with neuropathy?
neuropathy walking diabetes

Tingling, numbness and pain in the lower legs and feet are common symptoms which can make movement of any kind much more strenuous. At the same time, we are often told that exercise is one of the best ways to control diabetes. What’s a person to do?

The ADA recommends that people avoid weight-bearing exercise when experiencing numbness in the feet. While walking can be a good idea for some with less serious nerve damage, those who are walking with neuropathy should take the following precautions:

  • Discuss physical movement and exercise with a doctor first;
  • Walk only in areas where medical aids or emergency help are available if needed (for example, a stroll down the street or through the house is less dangerous than a hike in the woods);
  • Wearing proper therapeutic shoes, even when moving around inside.  One pair of diabetic shoes and three sets of therapeutic inserts purchased from an approved supplier are covered by Medicare each calendar year.

Did you know that therapeutic shoes for walking with diabetic neuropathy are covered by Medicare?

No Cost Shoes is a Medicare-approved company that offers shoe fittings and delivered-to-your-door shoes at no cost to you. Those who have nerve damage in their feet with no diabetic component or who do not have insurance can also purchase affordable shoes through our easy-to-use system. Simply visit nocostshoes.com or call us at 1-866-923-2423 to order a free catalog today.

The Diabetes Circulation Checklist: Are You Doing These 8 Things?

If you’ve seen a podiatrist for diabetes-related concerns, chances are you’ve heard the word “circulation” mentioned a few times. But what does circulation with diabetes really mean? More importantly, how can people avoid the blood flow related risks that come with a diabetes diagnosis?

This article will help you understand and respond to common circulation concerns with diabetes. We’ll explain exactly what risk factors are involved, then provide you an easy-to-follow checklist to stay as healthy as possible on a daily basis.

What is circulation and why does it matter so much for people with diabetes?

Circulation is another word for “blood flow.” When you have poor circulation, it means that one or more body parts are not getting enough blood.  Poor circulation can have many causes, from something as simple as bad fitting shoes through to some something as serious as a heart disorder.

Circulation matters for everyone, but people with diabetes should pay particular attention to this issue. High blood glucose levels caused by diabetes can damage blood vessels, limiting their ability to transfer blood to other cells. This can affect the flow of blood throughout the body.

One of the most common consequences of poor circulation in people with diabetes is foot complications. The word for feet or legs with poor circulation is “peripheral artery disease.”

Luckily, there are ways you can prevent and/or manage poor circulation. We’ve created this Diabetes Circulation Checklist to help guide the process.

Your Diabetes Circulation Checklist

□  Quit smoking. This is a tough one for many, but smoking has the biggest impact on your circulation as a diabetic.  If you want to prevent circulation issues, putting down cigarettes should be at the top of your “To Do” list.

□  Do some exercise several times per week. Don’t worry, we aren’t asking you to run a marathon (in fact, you don’t even need to hit the gym!). Just a brisk, 30-45 minute walk several times per week should do the trick.  Movement stimulates blood flow in legs, which can prevent peripheral artery disease. For more exercise tips for people with diabetes, click here.

□  Wear therapeutic shoes. Medicare and most insurance plans cover diabetic shoes for patients with a prescription. Approved supplier nocostshoes.com will even send a shoe fitter to your home to help you access shoes with no out of pocket cost. If you don’t have a prescription, you can still order shoes at low cost from their website.

□  Visit a podiatrist regularly. The best person to write your shoe prescription is a medical specialist who deals with foot issues. Annual visits to this type of doctor, called a podiatrist, are also covered by Medicare. They’ll also be able to identify any warning signs of circulation issues and give you tips on how to manage other foot conditions you may have.

□  Take a break when in pain. Regular exercise is important for managing circulation issues, but pushing yourself too far can have serious consequences. People with circulation issues may feel pain in their calves when walking, especially if they are moving quickly, uphill, or on a hard surface. Stop to rest if you are experiencing this, and speak to your doctor as soon as you can.

□  Wear warm support socks. Socks that are too tight or thin can worsen circulation issues for people with diabetes. Diabetic support socks can aid in circulation. They also help to warm up chilly feet, which is a common symptom for those experiencing circulation issues. Do not use hot water or heating pads to warm up your feet, as nerve damage may prevent you from feeling burns.

□  Examine your feet on a daily basis. Many telltale signs of poor circulation are evidence in the feet. Keep an eye out for sores that won’t heal, discoloration, shiny skin and slow toenail growth. If you see anything unusual, discuss it with your podiatrist.

□  Elevate your feet when you are sitting. Paying attention to your feet is important even when you’re not moving. Elevation and wiggling toes from time to time are great ways to encourage blood flow.