Does Medicare Cover Podiatry For Diabetics?

When a person is dealing with diabetes, they also may experience related medical conditions. In many cases, diabetes causes medical conditions related to the eyes, blood, and feet or legs. And to treat conditions in the legs caused by diabetes, some podiatric services and equipment are important.

If you’re in a situation where you need leg/foot treatment due to diabetes, you may be wondering “does Medicare cover podiatry for diabetics?” In this article, we answer that question in clear, plain English.

Does Medicare Cover Podiatry For Diabetics?

The short answer is yes. Medicare will cover the cost of podiatry for diabetic patients. 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 your podiatry services for diabetes. Find out what these conditions are and more about coverage below.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for podiatry services for diabetics. Parts A and B cover many forms of treatment for diabetes. Original Medicare provides coverage for podiatry for diabetic patients as long as it is medically necessary. Coverage for podiatry services for diabetics is provided by Medicare Part B.

Medicare Part B provides coverage for foot exams every year if you are experiencing lower leg complications that are caused by diabetes. However, for Medicare Part B to provide coverage for your yearly foot exams, you must visit your foot care provider for only that reason (and not another one).

Medicare Part B covers 80 percent of the costs of yearly foot exams. You will pay for the remaining 20 percent.

Aside from foot exams, Medicare Part B also provides coverage for diabetic shoes. Medicare Part B will provide coverage for the fitting as well as the furnishing of your diabetic shoes along with shoe inserts. Medicare Part B will cover one pair of custom-fitted shoes and inserts, as well as one pair of extra depth shoes.

To add to that, Medicare Part B will also provide coverage for two additional pairs of inserts for custom-molded shoes and three pairs of inserts for extra depth shoes every year.

However, for Medicare Part B to provide coverage for your diabetic shoes and inserts, your healthcare provider needs to provide a prescription. Your healthcare provider must also be Medicare-approved.

Once approved, Medicare Part B covers 80 percent of the costs of diabetic shoes and inserts. You will pay for the remaining 20 percent.

Part C Coverage for Podiatry for Diabetics

Medicare Advantage plans (Medicare Part C) also provide coverage for podiatry services for diabetics. This is because Medicare Advantage plans have a requirement to cover all the same services, treatments, etc. that Original Medicare covers. However, the Advantage plans also offer additional coverage for things Original Medicare does not cover. Exactly what additional treatments and services an Advantage plan covers depends on the plan. The costs for the plan and additional coverage will also vary by plan.

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.