Does Medicare Cover Diabetic Shoes?
Diabetes is a medical condition that affects over 30 million people in the United States. Diabetes causes the body to either not produce enough insulin or have difficulty processing insulin. As a result, people with diabetes face many side effects that range in severity.
One of the most challenging aspects of diabetic life is the development of peripheral neuropathy, or nerve damage that affects the arms, legs, hands, and feet. Peripheral neuropathy leads to tingling and numbness in the extremities, and while not explicitly painful, the condition can cause discomfort, mobility concerns and the potential to develop injuries that go unnoticed.
Many individuals with diabetes are seniors who may be concerned about the cost of their care with Medicare.
How is diabetic peripheral neuropathy treated?
Peripheral neuropathy resulting from diabetes can be treated in several ways, but the type of treatment seniors need for this condition can vary depending on the severity of symptoms. For some, medications that support nerve health can reduce symptoms; for others, insulin therapy may be required to help the body process insulin. Insulin injections are also a standard therapy for diabetics. Lifestyle changes can also be beneficial.
While a person with diabetes is undergoing treatment, special shoes can also be prescribed to mitigate the effects of neuropathy in the feet. So-called diabetic shoes feature additional cushioning specially designed to reduce rubbing. If a person with diabetes develops ulcers on the feet, these injuries can go unnoticed due to peripheral neuropathy. This, in turn, can lead to infection, and people with diabetes stand a higher chance of facing foot amputation when this happens. Diabetic shoes look and function like regular shoes and are available in various styles, colors and sizes.
Does Medicare cover diabetic shoes?
Medicare benefits are available for diabetic shoes through the outpatient portion of the program known as Medicare Part B. This part of Medicare insurance typically covers outpatient medical care services but also offers coverage for durable medical equipment (DME). This is medical equipment prescribed to Medicare recipients for medically necessary reasons.
Under Medicare Part B, people with diabetes pay 20% of the cost of diabetic shoes. Medicare covers the remaining 80%, but you must meet your Part B deductible before taking advantage of this benefit. Medicare Part B deductibles can change yearly, but in 2023, the Medicare Part B deductible is $226. Additionally, Medicare recipients must stay current on their Part B monthly premium, which can vary. For 2023, the standard Medicare Part B premium is $164.90, but this amount may go up based on your income level.
Where can I purchase Medicare-approved diabetic shoes?
Any covered diabetic shoes must come from a Medicare-approved supplier. Many shoe stores and department stores sell diabetic shoes and inserts. Still, purchases of diabetic shoes from these sources will not be covered by Medicare benefits unless the retailer is on Medicare’s list of approved suppliers. If you purchase diabetic shoes or inserts from a non-approved source, you will be responsible for the total cost.
What Are the coverage limits for diabetic shoes?
There is no limit to Part B Medicare benefits for outpatient services. Still, the benefit for diabetic shoes is limited to one pair of custom-molded shoes and inserts and one pair of extra-depth shoes per benefit period. Medicare recipients can, however, also receive coverage for two more pairs of inserts for custom-molded shoes and three additional inserts for extra-depth shoes per calendar year.