medicare diabetes

5 Medicare-Covered Professionals You Need on Your Diabetes Treatment Team

Diabetes management plans often include many different elements: monitoring blood pressure, adjusting diet, and protecting feet to name a few.

Medicare and most insurance plans respond to these needs by covering health services for people with diabetes. Combined with coverage for medical equipment (such as diabetic shoes) and medications, regular appointments with these professionals can make a big difference for diabetes management. Here are the 5 professionals that are worth adding to any diabetes care plan.

1) Your family doctor (MD).

We started with this professional because they are the absolute foundation of any diabetes treatment plan. According to Cleveland Clinic, insulin-dependent people with diabetes should see their doctors at least once every 3-4 months, while once every 5-6 months will usually suffice for those treated by pills.

Making the most of these appointments is critical. Something that seems small, such as mild foot pain or lower stamina, could be serious when diabetes is involved. To ensure your bases are covered, provide your doctor with all detailed information they may need at each appointment. This includes recent glucose readings, dietary or exercise changes, and reports of any pain or health challenges (however mild they may seem).

If your doctor recommends any durable medical equipment to help with your diabetes management, such as diabetic shoes or a continuous glucose monitor, be sure to ask them about what paperwork you will need to submit for Medicare coverage. Suppliers like nocostshoes.com can also fax the necessary forms to your doctor prior to ordering, but it can help to bring this up at appointments as well.

2) An optometrist/ophthamologist

To understand why seeing an eye care specialist is important, look no further than the statistics on diabetes and eye disease. Diabetic retinopathy is the leading cause of blindness in U.S. adults. As of 2010, 7.69 million Americans had reported a case of diabetic retinopathy, a number which continues to steadily increase each year.

The functioning of eyes is greatly affected by the functioning of blood vessels – in fact, it is not uncommon for an optometrist to identify the first symptoms of diabetes. For this reason, Medicare covers annual diabetic retinopathy exams. Making and keeping these appointments is important in protecting eyesight for individuals who have diabetes.

3) A podiatrist.

Serious foot issues and amputation is one of the lesser-known risks of diabetes, though ignoring it can lead to devastating consequences. With diabetic neuropathy, even small foot injuries can become quite serious over time.

To prevent these extreme consequences, Medicare extends coverage for a foot exam once every six months to those with diabetes-related nerve damage. In addition, Medicare often covers diabetic shoes through nocostshoes.com for qualifying individuals. This care protects feet as well as improving your comfort and quality of life as you move through your day.

4) Diabetic Self-Management Training (DSMT)

Managing diabetes often requires significant life changes. Many of these changes must be managed by the individual with the diagnosis, which is why Diabetic Self- Management Training is such an important tool.

In the first year, Medicare may cover up to one hour of individual training and up to nine hours of group training. Following that, 2 hours of follow-up training per year may be covered. This training must be conducted by a certified individual and be deemed necessary by your doctor in order for coverage to be offered. Fortunately, most doctors will deem DSMT a necessary service for their patients, especially those who struggle with some aspects of adapting to life with diabetes. The one-on-one training option is particularly helpful for those struggling with particular aspects of diabetes management.

5) A registered dietician.

registered dietician diabetes — Doctor Giving Advice On Healthy Diet

Along with diabetic self-management training, a dietician can help people understand how best to adapt their diet following a diabetes diagnosis. Since food is such an important aspect of diabetes management, Medicare has extended additional coverage to help those who need a registered dietician as they transition into this new lifestyle.

Depending on what is deemed “medically necessary” by your family doctor, this coverage could entitle you to a nutrition and lifestyle assessment, individual support and/or group nutrition therapy services, and follow-up appointments. A dietician can clarify the best eating choices for your health and educate you on proper nutrition to improve your health going forward.

Need more support? Proper communication with your family doctor is the key.

There are many different health care services and equipment that can help you to manage diabetes. Medicare or insurance coverage of these things is often contingent on your doctor filling out a Certificate of Medical Necessity. To determine what is medically required for your care, they need to have all the information in front of them.

So, if you are struggling with diabetes self-care, eating changes, or foot/eye issues, be honest and let your doctor know! There are many things they can do to help you access additional care.

For information on diabetic shoes and durable medical equipment covered by Medicare, visit nocostshoes.com.

Medicare won’t cover my therapeutic shoes. Now what?

At No Cost Shoes, we’re often surprised by how many people are unaware of Medicare’s coverage of shoes for diabetic Americans. It’s a huge benefit, and one that can make a big difference in the lives of people with diabetes. But, as more people find out about this coverage, those who do not qualify have started asking: “What can I do if I want diabetic shoes and Medicare won’t cover them?” Luckily, there are a few steps you can take if you find that coverage is not available to you at this time.

What are the Medicare requirements for diabetic shoe coverage?

In order for Medicare and most insurance plans to cover diabetic shoes, a doctor must attest that the patient needs them by filling out a Certificate of Medical Necessity (CMN). Patients may qualify for a CMN if they have both diabetes and a pre-existing foot condition of some kind. Qualifying foot conditions include:

history of partial or complete foot amputation
history of previous foot ulceration
history of preulcerative callus
nerve damage because of diabetes with signs of problems with calluses
poor circulation
foot deformity

Some people have diabetes but are unaware if they have any foot condition. Others may have foot conditions but not be diabetic. For these individuals (many of whom can still benefit a great deal from diabetic shoes!) there are a few options.

Tip #1: Visit a podiatrist to confirm whether you have any hidden foot issues.

Although your family doctor is often the one filling out a CMN for your diabetic shoes, early warning signs of diabetic neuropathy and other foot conditions are most likely to be identified by a podiatrist.

If you have diabetes, Medicare covers one foot exam every 6 months. Take advantage of this coverage and maintain regular appointments to stay on top of your foot health. If you have a hidden condition that may entitle you to free diabetic shoes, or if you develop one in the future, a podiatrist can identify the first signs.

Tip #2: Look online for affordable diabetic shoes.

Many people with and without diabetes who do not qualify for diabetic shoes covered by Medicare still benefit from therapeutic footwear a great deal. It can increase comfort and mobility, as well as playing an important role in preventing amputation and associated foot issues. However, the high-priced specialty shoes that a local medical supplier or podiatrist may sell can be out of the price range of someone without coverage.

Online suppliers are a great option here. Even without coverage, you’ll want to look for a Medicare-approved supplier, such as nocostshoes.com, to ensure you are getting a high-quality product. In our case, therapeutic shoes with specialty inserts cost only $99 online – much less than you would pay in a specialist’s office.

Tip #3: Check your health insurance for additional coverage options.

Some insurance companies cover orthotics for a wider range of patients, so it’s a good idea to have a closer look at your policy before paying out-of-pocket for your shoes. Contact your insurance company to clarify the conditions they may have for covering orthotics, therapeutic shoes, and other specialty items, particularly if a doctor recommends them.

If you purchase your own insurance coverage instead of getting it through an employer, it can be helpful to “shop around” for a provider with a workable policy on durable medical equipment such as therapeutic shoes. These policies can also help cover the deductible for Medicare coverage, which can eliminate out-of-pocket cost if and when you do qualify for shoes.

Additional questions? Give us a call!

At No Cost Shoes, we are diabetic shoe experts. With direct billing options to both Medicare and insurance, we know exactly how coverage works. We can also offer great, affordable options to those who are not currently eligible for coverage. For more information, call us at 1-866-923-2423. You can also check your eligibility for coverage using our easy online portal here.

My Podiatrist Doesn’t Sell Diabetic Shoes Anymore. Now What?

Many people with diabetes are used to buying their diabetic shoes and inserts from their podiatrists. But as Medicare rules continue to change and tighten, doctors are increasingly choosing to no longer sell shoes directly to patients. Although this may be necessary for the viability of the clinic, it can be a challenge for both patients and doctors, who may wonder, “Where can I get diabetic shoes now that my podiatrist or doctor does not sell them?”

Podiatrists will often point their patients to nocostshoes.com. Nocostshoes.com is an easy-to-use, Medicare approved service from Quantum Medical Supplies. We offer in-home shoe fitting and diabetic shoe sales across the United States. Shoe buying services are available online or over the phone by calling 1-866-923-2423.

Whether you choose to buy shoes from nocostshoes.com or somewhere else, there are a few extra considerations you should make when purchasing shoes from someone other than a medical professional.

1. Make sure your diabetic shoe brand and supplier are Medicare approved.

One of the biggest mistakes people make when buying diabetic shoes is purchasing shoes that, while marketed as “therapeutic,” aren’t actually covered by Medicare. Medicare only approves specific brands and suppliers for coverage, so double-checking is a good idea.

There are a few ways to ensure you are purchasing Medicare or insurance approved diabetic shoes.

Buy your shoes from a store, shoe fitter or online supplier that offers direct billing to Medicare and insurance.
Contact Medicare to confirm that the shoes will be covered.
Check with your doctor or podiatrist to understand what specific kinds of shoes are covered under their prescription. The often have a good understanding of insurance coverage related to these items.

2. Get professionally fitted for your diabetic shoes.

Even if a podiatrist is not selling shoes to you directly, you will want a foot care professional involved in your purchase. Many insurers will only cover diabetic shoes that are custom fitted, which requires a professional shoe fitting. Custom fitted shoes are safer for your feet and more comfortable, so skipping this step is not advisable.

Even if your podiatrist no longer supplies shoes, there are a few options here:

Ask your podiatrist if they are able to offer a shoe fitting during your annual foot care appointment.
Ask your doctor for a recommendation of a professional who may be able to assist with this.
Book an in-home shoe fitting with No Cost Shoes. Simply call us at 1-866-923-2423 and a registered professional will come to your home to help to fit and order the best shoes for you.

3. Remember to get new shoes every year.

There’s a good reason Medicare covers a new pair of shoes each year: the material on your shoes will wear out over time, and regular replacement is critical to keeping your feet supported, comfortable and safe.

When you are not buying shoes from your podiatrist, it can be easy to forget your annual shoe purchase. Finding a new supplier and ordering shoes takes time, and many people procrastinate on this important annual purchase once their podiatrist stops supplying shoes. Here are a few tips to keep your diabetic shoes top of mind:

Ask your podiatrist’s office to contact you for your annual appointment (covered by Medicare) at the same time every year. Directly following this appointment, contact No Cost Shoes or visit your local therapeutic shoe supplier. After doing this for a few years in a row, it will become an easy-to-follow routine.
Remind your doctor and podiatrist of your need for diabetic shoes. This will ensure you get the right prescriptions each year, while also reminding you to replace your old shoes following appointments.
Tell a trusted family member, like a child or a spouse, about your need for diabetic shoes. They can help you to remember when it’s time to replace them.
Write a note in your calendar on a year from when you bought your first pair of shoes as a reminder to get a new pair.
If you purchase shoes from nocostshoes.com, keep an eye on your email for our annual reminder to get new shoes.

How to find a new diabetic shoe supplier near you

The internet has put many diabetic shoe brands and related products at our fingertips. Ordering online can be an easy option for many individuals – however, it’s important to double check issues like insurance coverage and proper fit before pressing “purchase.”

Whether you choose to use No Cost Shoes service or find another supplier, make sure you ask the right questions to the right people in order to keep your feet healthy and safe for the right price.

Click here or call 1-866-923-2423 to check your Medicare eligibility with No Cost Shoes.