Does Medicare Cover Diabetic Shoes and Inserts?

Therapeutic shoes or inserts are custom footwear that support and protect your feet if you have certain medical conditions (like a foot ulcer or deformity).

Therapeutic shoes and inserts refers to the furnishing and fitting of either one of these:

• A pair of custom-molded shoes (including inserts) if you can’t wear depth-inlay shoes because of a foot deformity, and 2 more pairs of inserts
• A pair of extra-depth shoes, and 3 pairs of inserts

In certain cases, Medicare may also cover separate inserts or shoe modifications instead of inserts.

You have diabetes and severe diabetes-related foot disease.

The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts.

A podiatrist (foot doctor) or other qualified doctor must order the shoes or inserts, and you must get them from one of these:

• A podiatrist
• An orthotist
• A prosthetist
• A pedorthist
• Another qualified individual

Medicare will only cover your therapeutic shoes if your doctors and suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren't enrolled, Medicare won't pay the claims they submit.

After you meet the Part B deductible, you pay 20% of the Medicare-approved amount (if your supplier accepts assignment).

It's important to ask your suppliers if they participate in Medicare before you get therapeutic shoes. If suppliers are participating suppliers in Medicare, they must accept assignment (which means they can charge you only the coinsurance and Part B deductible for the Medicare-approved amount). If suppliers aren't "participating" and don't accept assignment, there's no limit on the amount they can charge you.

Every calendar year, you can get

• Either one pair of custom shoes or inserts, or one pair of extra-depth shoes.
• Either 2 or 3 additional pairs of inserts, depending on your shoe type.