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does medicare cover orthotics

Does Medicare Cover Orthotics For Plantar Fasciitis?

Imagine waking up in the morning, and as you step on the floor, you feel a sharp pain in your feet. If you know what this feels like, it may mean that you are suffering from plantar fasciitis.

One way to relieve that is by using orthotics. And custom-made orthotics tend to be more effective.

For those in need of orthotics, a common question is “does Medicare cover custom orthotics for plantar fasciitis?” In this article, we answer this question in clear, plain English. You will also find the average costs of custom orthotics for plantar fasciitis, as well as other helpful info.

Does Medicare Cover Custom Orthotics For Plantar Fasciitis?

The short answer is yes; Medicare will cover the cost of orthotics for plantar fasciitis. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for them. Below we look at what these are so you know what to expect.

Medicare considers orthotics, both off-the-shelf and custom-made, as Durable Medical Equipment (DME). DME is under the coverage of Medicare Part B.

But for Medicare to cover custom orthotics, they must be “medically necessary.” First you will need a prescription from your health care provider. Also, the supplier you get the orthotics from must also be Medicare-approved and accept Medicare assignments.

If all the requirements are met, Medicare Part B will cover 80% of the cost of orthotics.

How Much Does Custom Orthotics Cost?

Custom-made Orthotics usually costs between $300 and $600. Off the shelf orthotics range anywhere from $10 – $200.

What Is Plantar Fasciitis?

Plantar Fasciitis is a condition that involves inflammation of the Plantar fascia. This thick tissue extends from the bottom of your foot and connects your heel bone to your toes.

It usually occurs when you wake up and take your first steps. As you step, you will feel severe pain, but the pain will decrease as you move. The pain might return if you stand up after sitting or if you stand up for an extended period of time.

It commonly occurs in runners, especially those who run for long-distances. Also, overweight people and people who wear shoes without enough support are at high-risks of having plantar fasciitis.

What Are The Symptoms Of Plantar Fasciitis?

The most common symptom of plantar fasciitis is the stabbing pain and stiffness felt in the heel and even on the foot’s middle bottom. Other symptoms may include swelling and sensitivity of the bottom of the foot.

How Can Orthotics Help Against Plantar Fasciitis?

Orthotics can help treat plantar fasciitis as they reduce stress on the plantar fascia, giving enough support on the feet. Orthotics with a deep heel seat also absorbs shocks which reduces impact and pressure on the feet.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover dog bites?

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