Medicare Part B (Medical Insurance)
covers the furnishing and fitting of either of these each calendar year, if you have diabetes and severe diabetic foot disease:
- One pair of custom-molded shoes and inserts
- One pair of extra-depth shoes
- 2 additional pairs of inserts each calendar year for custom-molded shoes.
- 3 pairs of inserts each calendar year for extra-depth shoes
Medicare will cover shoe modifications instead of inserts.
Your costs in Original Medicare
If your supplier accepts assignment, you pay 20% of the Medicare-approved amount, and the Part B deductible applies.
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 submitted by them.
It’s also important to ask your suppliers if they participate in Medicare before you get therapeutic shoes. If suppliers are participating suppliers, they must accept assignment. If suppliers are enrolled in Medicare but aren’t “participating,” they may choose not to accept assignment. If suppliers don’t accept assignment, there’s no limit on the amount they can charge you.
Note
To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:
- Other insurance you may have
- How much your doctor charges
- Whether your doctor accepts assignment
- The type of facility
- Where you get your test, item, or service
Note
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Things to know
The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts.
The shoes and inserts must be prescribed by a podiatrist or other qualified doctor and provided by one of these:
- A podiatrist
- An orthotist
- A prosthetist
- A pedorthist
- A RPh