Therapeutic shoes or inserts
How often is it covered?
Medicare Part B (Medical Insurance) covers one pair of therapeutic shoes and inserts as durable medical equipment (DME), and the fitting each calendar year. Medicare will cover shoe modifications instead of inserts.
Who's eligible?
All people with Medicare who have diabetes and severe diabetic foot disease are covered. Your doctor must certify that you need therapeutic shoes or inserts. A podiatrist or other qualified doctor must prescribe these items and they must be provided by one these:
- A podiatrist
- An orthotist
- A prosthetist
- A pedorthist
Your costs in Original Medicare
You pay 20% of the Medicare-approved amount . Medicare pays for different kinds of DME in different ways. Depending on the type of equipment, you may need to rent the equipment, you may need to buy the equipment, or you may be able to choose whether to rent or buy the equipment.
Medicare will only cover your DME if your doctor or supplier is enrolled in Medicare. If a DME supplier doesn't accept assignment , Medicare doesn't limit how much the supplier can charge you. You may also have to pay the entire bill (your share and Medicare's share) at the time you get the DME.
Competitive Bidding Program
If you live in or visit certain areas, you may be affected by Medicare's Competitive Bidding Program . In most cases, if you have Original Medicare and get competitively bid equipment and supplies in competitive bidding areas , Medicare will only help pay for these equipment and supplies if they're provided by contract suppliers. Contract suppliers can't charge you more than the 20% coinsurance and any unmet yearly deductible for any equipment or supplies included in the Competitive Bidding Program.