Foot care is important for your mobility and quality of life, and it’s vital for patients who have diabetes or other chronic illnesses. If you’re over 65, you might wonder what Medicare covers when it comes to foot care.
Does Medicare cover foot problems?
Yes, Medicare Part B covers exams and treatment of the feet, ankles and lower legs, if:
- You have diabetes-related nerve damage.
- Need medically necessary treatment for foot injuries or diseases, like hammertoe, heel spurs or bunions.
This coverage includes x-rays, laboratory tests, physical therapy, durable medical equipment or prescription drugs ordered by a podiatrist.
Medicare Advantage (Part C) plans also cover podiatry, but you’ll need to ensure your provider is in your plan’s network.
How often can I go to a podiatrist on Medicare?
Medicare covers a foot exam once a year if you have diabetes-related lower leg nerve damage that could cause you to lose a limb. You can use this benefit if you haven’t seen a foot-care professional for another reason between visits. Diabetes-related foot care may include treatment of foot ulcers, calluses and toenail management depending on your needs.
How often does Medicare pay for routine foot care?
Part B doesn’t usually pay for routine foot care, a term defined as:
- Trimming or clipping nails.
- Removing corns and calluses.
- Hygienic or preventative care, like soaking feet.
However, there are times when Part B covers the above services. For example, when they are:
- For the treatment of warts.
- For the treatment of infected toenails.
- A necessary part of other services, such as the treatment of ulcers and wounds.
- When the patient has a systemic disease, and routine foot care by a nonprofessional would put the patient at risk.
With Original Medicare (Part B), you’ll have to pay all the costs of routine foot care outside those exceptions.
Remember, Medicare Advantage (Part C) plans sometimes cover services beyond those available under Part B. Check your plan to see if routine foot care is an extra benefit. You might be covered.
What does foot care cost with Medicare?
For services covered by Part B, after you meet the $233 annual deductible you will pay 20 percent of the Medicare-approved amount. If your foot care involves outpatient hospital treatment, you also will have a copay.
If you have Medicare Advantage, consult your specific plan for information about deductibles, coinsurance and copays.
Does Medicare pay for therapeutic shoes?
Yes, Part B covers therapeutic shoes, if you have diabetes and severe diabetic foot disease.
You’ll be able to get a pair of custom-molded shoes and inserts, or a pair of extra-depth shoes, each calendar year. Also, Medicare will cover two extra pairs of inserts for custom-molded shoes or three pairs of inserts for extra-depth shoes in a year.
After meeting your Part B deductible, you’ll pay 20 percent of the Medicare-approved amount for shoes and inserts.
For Medicare coverage to apply, the physician treating you for diabetes must certify that you need the shoes and inserts, and a podiatrist or other qualified doctor must prescribe them.
Part B will cover therapeutic shoes and inserts only if your doctor and shoe supplier are enrolled in Medicare. If a supplier doesn’t accept assignment, meaning they won’t take direct payment of the approved amount from Medicare, there’s no limit to what that supplier could charge you, and Medicare won’t cover it.
Where can I find a primary care physician who accepts Medicare patients?
Primary care doctors help their patients manage chronic illnesses and are a doorway to specialized care, like podiatry.
NewPrimaryCare.com™ can help you find a quality primary care doctor near you. Our preferred providers practice value-based care, meaning Medicare rewards them for helping patients get better.
With a value-based care doctor, you can expect quicker appointment scheduling, shorter waits at the doctor’s office and a meaningful connection with your physician.
Use our Find Your Doctor tool to search for and compare value-based care providers near you.
