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Therapeutic Shoe Bill
Resources
Therapeutic Shoe Bill
If you have diabetes, Medicare or your insurance company may pay for shoes or sneakers, leaving you with no out-of-pocket cost. Medicare has specific coverage guidelines regarding what shoes it will cover and for what conditions.
In general, if a beneficiary has Medicare Part B, has diabetes, and meets the specific conditions outlined below, Medicare will cover one pair of therapeutic shoes per calendar year if the qualifying conditions remain.
Types of Shoes Covered
The types of shoes Medicare covers yearly include one of the following:
- One (1) pair of depth-inlay shoes and three (3) pairs of inserts
- One (1) pair of custom-molded shoes (including inserts) and two (2) additional pairs of inserts
Qualifying Foot Conditions
The beneficiary must be treated under a comprehensive diabetes care plan and need therapeutic shoes or inserts because of diabetes to qualify for Medicare coverage of therapeutic shoes. They must also have at least one of the following conditions in one or both feet:
- Partial or complete foot amputation
- Past foot ulcers
- Calluses that could lead to foot ulcers
- Damage caused by diabetes with evidence of callus formation
- Poor circulation
- Deformed foot or feet
Medicare Eligibility Requirements
For Medicare to pay for a beneficiary's therapeutic shoes, the doctor treating their diabetes must certify that the beneficiary has diabetes and that:
- A podiatrist or other qualified doctor prescribes the shoes
- A doctor or other qualified individual fits and provides the shoes.
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