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!


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.

How to Pick the Best Diabetic Walking Shoes

For people with diabetes, getting enough exercise is almost as important as a healthy diet. And when it comes to finding an easy and affordable form of exercise, it’s hard to beat good, old-fashioned walking.

But before you hit the pavement, you need to ensure you’re wearing the proper diabetic walking shoes. People with diabetes are at a high risk of developing impaired circulation in their feet and nerve damage, and wearing ill-fitting shoes can seriously increase your chances of developing a harmful condition. Since diabetes also affects the body’s ability to heal, even a minor skin irritation can lead to a lengthy recovery period.

woman walking in comfortable shoes

Here’s the good news: Medicare covers one pair of diabetic shoes and two pairs of customer inserts per year for adults with diabetes. All you need is a prescription from your doctor, size details from a qualified shoe fitter, and a supplier that is approved by Medicare (hey, that’s us!).  To learn whether you qualify for this coverage, click here.

Factors to Consider When Choosing Diabetic Walking Shoes

When choosing a diabetic walking shoe, you will want to ask yourself the following questions:

Are they comfortable?

Make sure that the toe box (front of the shoe) is wide enough for your toes to easily move around. You will also want to look for shoes with good insole cushioning and avoid shoes with interior stitching as they can cause friction that can lead to skin irritation. If you have any protrusions on your feet such as bone spurs or bunions, look for diabetic walking shoes that don’t put pressure on those areas. Another option is to look for high-quality shoes that can be stretched in those tighter spots.

Are they breathable?

Natural fabrics such as canvas, leather or suede are the best choices as they are the most breathable. Breathability is an important factor for people with diabetes to consider when picking a walking shoe as excess moisture can lead to blisters and fungal infections. Shoes with perforations or mesh inserts can also help with this.

Are they easily adjustable?

Diabetic walking shoes should be adjustable to accommodate swelling or the need for extra padding and inserts. Look for shoes with laces or buckles that can be easily loosened when needed. Velcro walking shoes usually provide the most flexibility in this area. On the other hand, open-toed shoes, thong sandals, flip-flops, and high heels are too rigid and don’t provide the necessary protection that people with diabetes require from their footwear.

The Best Walking Shoes for Diabetes

new balance women's walking shoes diabetes beige velcro

New Balance Women’s Diabetic Shoes
These shoes offer a padded interior for extra comfort and their velcro closure make them easily adjustable.

walking shoes diabetes men dr. comfort black

Dr Comfort Men’s Diabetic Shoes 
The mesh tongue adds breathability while the wide toe box offers ample room for movement.

orthofeet diabetic walking shoes

Orthofeet Men’s Diabetic Shoes
The perforations along the sides and toe box of this pair add much-needed breathability.

How to Pick the Best Diabetic Walking Shoes for You

The most important thing when picking diabetic walking shoes is to ensure the size is correct. This will allow for proper circulation. Your feet can change size and shape over time, so most insurance companies and Medicare require you to repeat this step each time you get new shoes. Set up an appointment with your podiatrist to have this done, or use No Cost Shoes’ easy and free service to have a trusted professional come to your home for a shoe fitting.

When you try on your shoes, make sure you’re wearing the type of sock or stocking you would typically wear. You will also want to bring any orthotics and inserts that you will be using with your shoes.

So You’ve Picked Your Shoe, Now What?

While picking a well-fitting shoe is a big part of proper foot care, there are not the only thing you should do to keep your feet healthy and happy. Try to reduce pressure on your feet by alternating your walking shoes every five hours or by giving your feet time to breath. You will also want to promote proper blood circulation by taking the time to extend your toes and move your ankles up and down ever three to four hours. If you notice any sores, blisters or swelling on your feet, alert your doctor immediately. Prompt treatment is critical to prevent minor injuries from developing into potentially life-threatening issues.

Finding your perfect pair of diabetic walking shoes doesn’t have to be a chore. As long as you keep the above recommendations in mind, you will be walking away in a comfortable pair in no time.

No Cost Shoes streamlines the process of getting a insurance and Medicare-covered shoes by sending a prescription to your physician, providing an in-home shoe fitting, and direct billing your insurance.