Are orthopedic shoes covered by Medicare? Yes, if they are part of a leg brace. But only if the supplier and doctor are enrolled. Non-enrolled suppliers and doctors are not eligible for Medicare coverage. They can charge you a coinsurance or your Part B deductible. Non-participating suppliers can charge an unlimited amount. Here's how to get a pair of orthopedic shoes covered by Medicare.
Custom-molded orthotics
If you have foot pain, then you should ask your doctor about a pair of custom-molded orthotics. This type of foot brace is medically necessary. Custom orthotics are made to fit a person's foot perfectly. Although most patients will not notice the difference, they will feel a difference after wearing them for at least six months. In addition to reducing pain and increasing flexibility, custom orthotics are covered by Medicare.
There are two types of custom-molded orthotics available. One type is the Robert's appliance, which is a metal or plastic device with a medial flange, lateral clip, heel seat, and plate extending to all metatarsal heads. Another type is the Shaeffer orthotic, which is made of rigid plastic. Medicare pays for custom-molded orthotics for patients who don't qualify for braces.
These orthotics are covered by Medicare if you have certain foot conditions or if your shoe is damaged or in need of modifications. The full-length inserts fit only casual footwear and shoes with removable factory inserts. If you need to wear more than one style of orthotics, they can add up very quickly. Medicare will cover up to 80 percent of the cost of these devices. Custom-molded orthotics are a necessary part of a comprehensive treatment plan.
For the most part, custom-molded orthotics are covered by Medicare when they are medically necessary. The Medicare part B coverage may cover up to 80 percent of the cost of the orthotics, with beneficiaries responsible for the co-payment or co-insurance for the rest. Medicare also requires that the supplier is approved by Medicare. Medicare pays for a pair of custom-molded orthotics if the patient has a specific medical condition.
Orthotics can be made of plastic, foam, or metal. The materials used in orthoses depend on the needs of the patient, but usually the material is solid. While there are exceptions, most are made of duralumin or steel. Orthotics are usually covered by Medicare if you have a problem with a specific foot type. If you have trouble finding a doctor, call your insurance company and make an appointment.
Depending on the type of orthotic you need, you may have to pay up to $850. This does not include the cost of office visits. However, you should also take into account the costs for resurfacing your orthotic inserts. Resurfacing will cost around $50. Over time, the plastic or EVA foam material used in orthotics will wear out and need to be replaced. The cost for resurfacing an orthotic can range from $50 to $100.
Stock shoes
If you're looking to buy stock orthopedic shoes, you've come to the right place. MHCP covers these shoes as long as they're part of a leg brace. In addition, they must be medically necessary for the leg brace to function. Stock orthopedic shoes are also covered when the stock inserts are part of a foot pressure-off-loading device. Medicare will cover two pairs of orthopedic shoes and two pairs of foot pressure-off-loading devices per calendar year if they are prescribed by a physician.
Depending on the severity of the pathology, the type of shoe will be determined. A group of patients should be observed regularly to monitor any changes. Stock shoes may consist of standard therapeutic Oxford dress shoes, casual shoes, and walking/exercise shoes. Depending on the condition, a patient may require special boots with ankle support. In such a case, a prescription may be needed. But a pair of stock shoes should be sufficient.
You can shop around for a Medicare plan that covers these items. Medicare Part B pays for about 80 percent of the cost of approved orthotics. But you have to find a Medicare-participating supplier. Stock orthopedic shoes are covered by Medicare when they fit properly and are designed to correct a particular condition. In these cases, your doctor may prescribe an orthotic device for you. A leg brace can also fall under the definition of durable medical equipment.
Custom-made orthopedic shoes may require multiple trial fittings. Usually, custom-made orthopedic shoes are obtained when a foot disorder is severe enough to require a physical presence. Initially, you may need to undergo a trial fitting to ensure that they are comfortable and are made for your specific needs. However, if you are covered by Medicare for such shoes, then it's worth the hassle. You can get the exact model you need based on the severity of your foot condition.
Diabetic shoes
If you suffer from diabetes, you may be surprised to learn that your health insurance covers diabetic shoes and moldable insoles. Medicare covers 80 percent of the cost of these shoes and insoles. Most medical insurance plans cover the cost of diabetic shoes with some exceptions. Your doctor can prescribe them for you, or you can buy them online. Diabetic shoes can cost $50 to $200 per pair. Medicare covers them for people with diabetes, but they are not covered for everyone.
If you are enrolled in Medicare's Advantage Plan, you may be eligible for Medicare coverage of diabetic shoes and inserts. If you have a Medicare Advantage Plan, you may have to fill out a special application for diabetic shoes. You can call the customer service department and ask about diabetic shoes and inserts. You may also qualify for a partial reimbursement. For example, Medicare may cover one pair of custom-molded shoes with inserts. Other options include purchasing separate inserts or changing the shoe's style.
Diabetic shoes are available in many styles and colors. Medicare covers them when you visit a supplier or physician that accepts Medicare. However, you must still meet certain requirements to be eligible for Medicare. Also, if you have a Medicare Advantage plan, you may not be able to get the shoes you need without visiting a doctor's office. Visiting a doctor in the Medicare Advantage plan will not guarantee coverage for the shoes, so make sure to check before you start your shopping.
You can also apply for reimbursement if you have diabetes. The Therapeutic Shoe Bill (or TSHB) was passed by Congress in 1993, and the government has been paying for diabetic shoes since then. It is important to note that the Medicare reimbursement only applies to therapeutic shoes, and the supplier and physician have to be enrolled in the program. You may also need to meet the requirements and have your doctor's certification.
Diabetic shoes are also called extra-depth shoes, therapeutic shoes, or healing shoes. Their main function is to improve overall comfort, reduce skin breakdown, and protect the feet from foot complications. These shoes must also come with a removable orthotic. These inserts improve joint stability and prevent joint deformity. They also improve overall mobility. So, regardless of your insurance coverage, you're sure to receive the assistance you need.
If your doctor has deemed the shoes necessary for the care of your diabetes, your insurance company will reimburse you for them. Typically, prescription diabetic shoes are covered by Medicare Part B. To find out more about your specific coverage, visit the Medicare website. Diabetics are at a higher risk of developing foot problems, poor circulation, and nerve damage. A physician should be consulted prior to purchasing a new pair of shoes to prevent any complications.
