Wash Your Feet Every Day
Wash your feet with soap in warm, not hot, water. Test the water to make sure it is not too hot. You can use a thermometer or your elbow to test the warmth of the water. Do not soak your feet because your skin will get too dry.
After washing and drying your feet, put talcum powder or cornstarch between your toes. Skin between the toes tends to stay moist. Powder will keep the skin dry to help prevent an infection.
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How Do I Qualify For The Coverage Of Diabetic Shoes
You must be covered under Medicare Part B and all three of the following conditions are met:
1. You have diabetes and
2. You have one or more of the following conditions:
- Partial or complete foot amputation
- Past foot ulcers
- Nerve damage in your feet with signs of calluses on either foot
- Deformity of either foot
- Poor circulation in either foot.
3. Your doctor has certified your need in writing, and it states that:
- You meet the criteria for the shoes
- The doctor is treating you under a comprehensive plan of care for diabetes
- The exact reasons you need the therapeutic shoes and/or inserts
Remember:
- Only an M.D. or D.O. can sign the certification statement a podiatrist may write the prescription for the shoes, but the M.D. or D.O. who is treating your diabetic condition must certify it. While a podiatrist can prescribe diabetic shoes, they cannot sign the physicians certification statement.
- You will need a new order for the replacement of any shoe
- A copy of the certification statement and prescription must be kept on file by your supplier
- A new certification statement will be required for shoes, inserts or modifications each year they are purchased
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What About Medicare Advantage
Medicare Advantage, or Medicare Part C, are provided by private companies which are contracted by Medicare to provide at least the same services, and coverage, as Original Medicare Parts A and B, and some extra benefits, which Medicare allows them to offer.
This means that Medicare Advantage, or Medicare Part C, will cover Therapeutic shoes and inserts under the same guidelines as Original Medicare.
Each Advantage plan has its network of providers and suppliers, and these will be the only ones you are allowed to use if you are to receive coverage.
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Can Medigap Help Cover The Cost Of Diabetic Shoes
A Medigap policy may be just what you need to help cover your diabetic shoes. Medicare Supplement plans are a great asset in helping with extra costs. Because Medigap plans cover the balance of what Medicare does, Medicare Supplement policies can help cover the out-of-pocket expenses you may have when getting diabetic shoes.
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How To Control Type 1 Diabetes Without Medicine
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Orthopedic Shoes And Inserts Also Called Orthotics Can Be Used To Either Correct Foot Conditions Or To Relieve Symptoms Enough To Allow For Normal Mobility
They carry your weight around all day, every day, so its no surprise that many people experience issues with their feet even without an underlying medical issue. But throw in a condition that affects circulation, like diabetes, and foot problems are practically inevitable.
If you have diabetes, either your primary care doctor or your podiatrist may recommend treatment that includes either diabetic shoes or an orthotic insert. While these shoes and inserts can be expensive, they may be covered by Medicare for people with a diabetes diagnosis. Read on to learn more.
Do Medicare Advantage Plans Cover Diabetic Shoes
Medicare Advantage policies can cover the costs of your therapeutic shoes. Since Medicare covers diabetic shoes, Medicare Advantage plans will also cover diabetic shoes.
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Of course, you must still meet all eligibility requirements. Keep in mind, Advantage plans have specific networks. If your plans network doesnt include your doctor, you may not have coverage for your shoes or visits.
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What Kind Of Foot Care Does Medicare Cover
Medicare covers foot care that is considered medically necessary. For care to be considered medically necessary by Medicare, it needs to be prescribed by a physician or other licensed medical professional. Generally, Medicare will cover services you receive from a qualified podiatrist, although care from other physicians and providers might also be covered in some cases.
When you receive medically necessary foot care as an outpatient, it will be covered under . Some examples of foot care that would be considered medically necessary include treatment of:
If you receive foot care while youre admitted to the hospital, it will be covered under . Just like with Part B coverage, the foot care you receive in the hospital must be considered medically necessary to be covered.
No matter where you receive your foot care, it will need to be performed by a Medicare-approved provider to qualify for coverage.
What Diabetic Services Does Medicare Cover
4 min read / Written by
The first fact you need to know is that you must be enrolled in Medicare Part B for Medicare to cover your diabetic services or supplies. If you have a Medicare Advantage plan, youre required to be enrolled in both Medicare Part A and Part B, so as long as you continue paying your Part B monthly premium, you should be covered as described below.
If youre not sure whether youre enrolled in Medicare Part B, look at your red, white, and blue Medicare card, or contact your current health insurance provider.
Medicare Part B covers the following diabetic services, generally requiring your Medicare-participating doctors order:
- Diabetes screening: Medicare covers tests to check for diabetes if youre considered at risk for the disease. These screenings may include tests such as a fasting plasma glucose test, or other Medicare-approved tests your doctor may order for you. Medicare may cover these screenings up to twice a year, depending on your risk factors.
- Diabetes self-management training: For qualified beneficiaries, Medicare offers a training program that teaches you how to manage your diabetes. It includes education about self-monitoring of blood glucose, diet, exercise, and prescription medications. If you meet certain conditions, Medicare may cover 10 hours of initial diabetes self-management training, to be completed within a year, and two hours of follow-up training each following year.
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Need More Information On Medicare Reimbursement
We can provide a brochure to take to a Primary Care Physician to see if youre eligible and get the paperwork started. This pamphlet explains the process for both the patient and doctor with and includes simple instructions and forms the doctor needs to complete. It also has some important facts about diabetes foot health.
To receive this free brochure in the mail, along with one of our catalogs and a list of providers in your area, email your request with your name and address to
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How To Qualify For Medicare Diabetic Shoes
In order to qualify for Medicare covered diabetic shoes and diabetic insoles, a podiatrist must prescribe the items and the prescription must be filled by any of the specific health professionals as mentioned above. The prescribing doctor must complete a certificate of medical necessity for diabetic shoes and it must be documented in the patients medical records.
In order to qualify for the coverage of diabetic shoes, patients must be covered under Medicare Part B and meet all three of the following conditions:
1) Patient has diabetes
2) Patient has at least one of the following conditions:
- Partial or complete foot amputation
- Nerve damage in feet w/ signs of calluses on either foot
- Foot deformities such as hammertoes or bunions
- Poor circulation in the feet
3) Patients doctor certifies in writing stating that:
- The aforementioned requirements are met for diabetic shoes
- Patients certifying physcician is treating them for diabetes under a comprehensive plan of care
- Specific reasons why patient needs diabetic shoes and/or inserts
Medicare does not offer coverage for diabetic shoes if all three of these requirements are not met.
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Clinicians Are You Ordering Diabetic Shoes For Your Patients
This article has been revised as of March 2021.
The following section outlines roles of various practitioners that are involved in the decision-making and provision process for Diabetic Shoes:
- Certifying Physician: The practitioner actively treating and managing the patients systemic diabetic condition. This practitioner must be an M.D. or D.O. as outlined in the Social Security Act §1861 .
- Prescribing Practitioner: The Certifying Physician, a different MD or DO, physicians assistant , nurse practitioner , clinical nurse specialist , or podiatrist . One of these practitioners may conduct the foot exam and write the standard written orders required for Medicares coverage of Therapeutic Shoes for Persons with Diabetes if the Certifying Physician does not complete the foot exam.
- Supplier: The person or entity that provides the shoes and/or inserts to the Medicare beneficiary and bills the Medicare program. A supplier may be a podiatrist, pedorthist, orthotist, prosthetist or other qualified individual. The Prescribing Practitioner may be the supplier.
Recent Centers for Medicare and Medicaid Services Guidance and a new Center for Medicare and Medicaid Innovation recently expanded who may perform the role of the Certifying Physician as described below:
NPs or PAs providing ancillary services as auxiliary personnel could meet the incident to requirements if all the following criteria are met:
Where Do I Get My Diabetic Shoes
- In order to receive diabetic shoes, the prescribed patient must be fitted for diabetic shoes by a podiatrist or any other qualified individual.
- The certifying physician is not allowed to provide the patient with the footwear, unless they practice in a defined rural area or there is a shortage of health professionals
- The prescribing physician may be the supplier.
The M.D. or D.O. treating the patient for diabetes must certify that the individual:
1. Has diabetes.
2. Has one or more of the following conditions in one or both feet:
- history of partial or complete foot amputation
- history of previous foot ulceration
- history of preulcerative
- nerve damage because of diabetes with signs of problems with calluses
- poor circulation
3. Is being treated under a comprehensive diabetes care plan and needs therapeutic shoes and/or inserts because of diabetes.
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Propt Extra Wide Medicare
Propét is the leading company in extended widths footwear. Whether you need wider shoes because you have wider feet, swollen feet, or feet extremely sensitive to touch, you should have a look at the companys large catalog of choices.
All Propét shoes are available in 3 to 5 different widths in order comfortably accommodate any foot types. Both the Olivia style for women and the Scandia style for men are 100% leather shoes. Theyre easy to put on slip-on shoes with large adjustable velcro straps. They need to be broken in but once they do, theyre remarkably comfortable.
The interior of the shoe is smooth, seamless and fully padded to avoid blisters and friction points. The collar and tongues are fully padded for extra protection. The insoles are doubled to offer enhanced cushioning. Theyre removable if you prefer to insert your own orthotics.
Both these styles are Medicare-approved as diabetic shoes .
Propét Extra Wide Shoes: Cons
- Need to be broken in
The Average Cost Of Orthotics
Custom orthotics are much more expensive than the over-the-counter kind, but they’re also more effective. Without insurance, it may cost anywhere from $200 to $800 to have custom orthotics made. It could cost even more if your doctor orders a foot X-ray or performs other services before deciding that wearing orthotics is the best course of action. Over-the-counter orthotics may cost as little as $10 per set, but remember that they’re not customized for your feet, so they may not help with proper foot alignment.
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How Do I Qualify For These Benefits And What Rules Apply
Your condition needs to be under treatment by a physician to qualify for coverage. Your healthcare provider will need to show documentation that youre receiving treatment for a condition that requires foot care. Youll need to be receiving active care for 6 months for that condition for Medicare to begin paying.
Make sure youre enrolled in either Medicare Part B or a Medicare Advantage plan. Medicare Part A only covers hospital and long-term care expenses. Your podiatrist or other foot care provider will need to be enrolled in Medicare and accept assignment. If youre using a Medicare Advantage plan, you might need to use a provider whos in your plans network.
Your costs will depend on whether you have original Medicare or a Medicare Advantage plan.
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Patient Responsibility For Payment
Medicare will pay for 80% of the Medicare-approved amount either directly to the patient or by reimbursement after the Part B deductible is met. The patient is responsible for a minimum of 20% of the total payment amount and possibly more if the dispenser does not accept Medicare assignment and if the dispenserâs usual fee is higher than the payment amount.
Medicare pays only for therapeutic footwear from Medicare-approved suppliers, reimbursing 80% of the cost either to the patient or after the Part B deductible is met. The patient is responsible for the other 20% â or more if the supplier does not âaccept assignmentâ from Medicare.
Medicare.gov: Medicareâs Coverage of Diabetes Supplies & Services.
The National Institute of Diabetes and Digestive and Kidney Diseases of The National Institutes of Health. Publication: Feet Can Last a Lifetime: Medicare Coverage of Therapeutic Footwear for People with Diabetes. 1998.
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