Does Medicare Cover Shoe Inserts?

If you’re experiencing foot pain, one common treatment option is shoe inserts.

Shoe inserts, also known as orthotics, are usually prescribed by podiatrists to help relieve foot pain. Below, we look at what they cost, alternative options (plus what they cost) and answer the question “does Medicare cover shoe inserts?”

Does Medicare Cover Shoe Inserts?

The answer to this question depends on why you need the shoe inserts. Medicare will pay for shoe inserts for those with diabetes and sever diabetic foot disease. If you need them for another reason, unfortunately, you are out of luck.

If you do need them due to diabetes, then Medicare Part B will pay for a pair of custom-molded shoes and inserts as well as a pair of extra-depth shoes.

In addition to that, Medicare covers 2 extra pairs of inserts for your custom-molded shoes each calendar year. It will also cover 3 pairs of inserts for extra-depth shoes each calendar year.

Also, Medicare does cover modifications to shoes instead of inserts.

As is the case with Medicare coverage, you will only be covered for shoe inserts if your doctor/supplier is enrolled in Medicare. If not, your claim will be denied.

So make sure you are getting your shoe inserts from medical providers/suppliers who are part of Medicare BEFORE you make your purchase. You don’t want to be stuck paying for shoe inserts if they are not!

Because they are covered by Medicare Part B, Medicare will pay for 80% of the cost of shoe inserts. You will be responsible for the remaining 20% as well as your deductible.

What Do Shoe Inserts Cost?

Custom shoe inserts can be pricey. You can figure on them costing from $200 all the way up to $1,000. Private insurance often does not cover the cost of shoe inserts. If they are covered by insurance, figure somewhere between 10% – 50% of the cost will be covered.

How Much Do Orthotic Insoles Usually Cost?

There are alternatives to custom shoe inserts. Many stores sell pre-made orthotic insoles that can provide support and, in some situations, pain relief.

The cost of an orthotic insole depends on what material is used to make them and the quality of the product itself. Usually, the cheaper the insoles are, the lower the quality is. It may be tempting to purchase more affordable quality insoles because of their low prices. But you must know, lower quality insoles are more likely to wear out quickly and will not last for long. So you may end up paying more in the long run.

One type of orthotic insole is gel insoles. These are low-cost insoles and can cost between $10-20 per pair. A well-known brand that offers gel insoles is Dr. Scholls. Gel insoles are affordable and comfortable to your feet but will only last long for a few weeks.

On the other hand, Foam insoles have a wide variety of prices, depending on the quality. Many foam insoles can last longer than gel insoles and cost between $25-$55 as they have different attributes. Some are made of memory foam, while others are equipped with a thin base beneath the foam, providing more stability.

As usual, the higher the cost, the better the quality. However, foam insoles will not last long in everyday use and may only last up to six weeks.

Semi-rigid orthotic insoles are more durable and pricey compared to their gel and foam counterparts. A pair of semi-rigid insoles can cost between $50-$100 and are made out of firmer material, which can last for a few months. Some semi-rigid orthotics also include foam top, adding more comfortability, firmer arch support, and stability to relieve chronic foot pain.

Note: Medicare coverage changes all the time. Always be sure to double check with your health care provider and/or Medicare insurance provider about what is and isn’t covered by your plan.