Medicare Coverage for Diabetic Shoes

One of the problems associated with Diabetes is reduced blood flow to the feet. This is cause by damage to the nerve endings caused by the disease. As the disease progresses the blood circulation to the feet can lead to sores, ulcers and if left untreated, amputation. One of the side effects of the nerve damage is the inability to feel heat, cold, or pain in the feet at all. Diabetics must take very good care of their feet in order to notice problems when they first start and to keep blood flow to the feet as healthy as possible. One of the principal ways to do this is by wearing diabetic shoes.

What are Diabetic Shoes?

Diabetic shoes are shoes that are especially designed to protect the foot of a diabetic. The shoes often have a large "toe box" that allows movement of the toes and prevents the toes from being squeezed or chafed by the shoes. The shoes also often come with special insoles that help to prevent sores and prevent pain. The entire shoe is designed to distribute weight as evenly and comfortably as possible across the entire sole of the foot. This again prevents chafing and helps the foot to support the body's weight. Diabetic shoes are also designed for maximum ventilation so that the feet can breath. Letting air into the shoe prevents the foot from overheating and swelling. The most advanced types of shoes are actually molded to the person's feet. The insoles as well as the shoes themselves are custom designed to take into account the shape of the feet.

Diabetic shoes must be professionally fitted. A podiatrist usually does diabetic shoe fittings. Special diabetic shoes are often made of canvas so that the shoe is able to breathe. Sometimes more than one pair of shoes and insoles is needed to accommodate changes in weather and the seasons.

Eligibility for Diabetic Shoes

In order to be eligible for diabetic shoes you must either be diagnosed with diabetes by a Medicare-approved physician or you must be suffering from either a foot deformity or a problem related to poor circulation. Foot deformities include amputations of toes and deformities caused by poor circulation or other causes. Anyone who has had problematic foot ulcers or pre-ulcerous calluses caused by poor foot circulation is usually eligible for diabetic shoes. The shoes must also be prescribed and provided by a qualified Medicare-approved doctor and provider.

What Does Medicare Diabetic Shoe Coverage Include?

Medicare coverage for Diabetic shoes comes under the Durable Medical Equipment Clause of Original Medicare Part B. You must either be signed up for Part B or have an Advantage Plan. Medicare recipients with an Advantage Plan should read the plan specifications related to diabetes before choosing the plan to make sure that they can easily meet the rules and guidelines for diabetics. Under Original Medicare the patient pays 20% of the cost of the shoes and insoles.

Medicare coverage includes one pair of regular diabetic (depth-inlay) shoes and three pairs of custom fitted insoles per year. If a Medicare recipient has deformed feet and they are unable to be properly fitted to wear standard diabetic shoes, Part B will cover 80% of the cost for molded custom shoes and three pairs of insoles a year.