Podiatrists cover a wide range of issues that deal with the feet and lower legs. These issues can include injuries and conditions like hammer toes and heel spurs. They can also include complications related to diabetes and other health issues. A podiatrist can prescribe medications, order X-rays, perform surgery, and handle most any other medical need related to your bones, nerves, and muscles in that area.
Since nearly anyone—including yourself—could find themselves needing an appointment with a podiatrist, you might be wondering, “Does Medicare cover podiatry?” The short answer is yes, if the doctor deems their treatment medically necessary. However, it’s likely that Medicare won’t cover the full cost. Let’s get into more detail and discover what can help cover podiatry costs.
What podiatrist costs does Medicare pay for?
Medicare will pay for a range of medically necessary podiatrist costs for services and treatments. One major example is diabetic foot care. Diabetes can cause nerve damage in the lower extremities. Medicare will cover related treatments and appointments.
Medicare will also fully or partially cover orthotics for plantar fasciitis and other issues, prosthetic devices, and braces. The amount Medicare will cover will depend on your specific needs and which supplement plan you have.
Surgeries, like bunion removal and hammer toe surgeries, are covered under Medicare. You may find yourself paying out of pocket for the coinsurance or deductible, but you’ll potentially save thousands of dollars via Medicare.
Treatments for ingrown toenails and toenail fungus might be covered by Medicare, if your podiatrist deems them medically necessary. Be sure to ask your provider during your appointment.
Does Medicare cover podiatry for foot pain?
“Foot pain” can be caused by a variety of issues. If the treatment is deemed medically necessary by a podiatrist or primary care physician, then it will most likely be covered by Medicare. Again, talking with your provider will help you better understand what could be covered based on your needs.
Is a podiatrist covered under Medicare Part B?
For those with dealing with health issues like diabetes, diabetic peripheral neuropathy, and nerve damage, Medicare Part B can help. It will cover biannual foot exams, so you and your doctor can track any changes or needs for your care.
Medicare Part B and Medicare Advantage plans will also cover items such as prescribed walking boots and knee walkers.
With Medicare Part B, you may have to pay your deductible if you haven’t reached it yet. If you have met your annual deductible, you’ll have to pay the coinsurance cost, which is usually 20% of the service’s Medicare-approved amount. Finally, with outpatient services, you will need to pay your copayment.
How often does Medicare pay for routine foot care?
When it comes to routine foot care, Medicare does not cover services like nail trims, pedicures, corn or callus removal, and flat foot treatment. These are not essential or medically necessary treatments according to Medicare. If you’re not sure, check with your physician first.
Ready to set up a podiatrist appointment?
NewPrimaryCare.com™ can help you find a quality Medicare primary care doctor or podiatrist near you. All of our partner providers practice value-based care, so you can expect quicker appointment scheduling, shorter waits at the doctor’s office, and a meaningful connection with your physician.
Find a physician and podiatrist who will put your health first – search for a provider near you, or talk to one of our Primary Care Advocates to help guide your search by calling 800-587-9194.
