How Do You Get Diabetic Shoes Through Medicare?


Quick Answer

To qualify for diabetic shoes through Medicare, a doctor must certify that the patient has diabetes, has at least one qualifying condition in one or both feet, and has a comprehensive diabetic treatment plan, according to WebMD. The doctor also certifies that diabetes is the reason the patient needs the shoes.

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Full Answer

Qualifying conditions include amputation of part or all of the foot due to diabetic complications, a history of diabetic ulcers on the foot, a preulcerateive callus, neuropathy with callus formation, or poor circulation. Diabetics with foot deformities can also qualify for the shoes through Medicare, reports WebMD.

While the patient’s diabetic care physician serves as the certifying physician, a doctor of podiatry, orthopedic surgeon or other medical doctor writes the prescription. The patient takes the certification and prescription to a podiatrist, orthotist, prosthetist, or pedorthist then fits the shoes, states WebMD.

Medicare provides one pair of diabetic deep-inlay shoes annually, along with three additional sets of inserts. If the patient requires custom-molded shoes, it covers a single pair each year along with two insert sets. Medicare sets limits on the cost of shoes and pays the provider or reimburses the client for 80 percent of the cost up to its maximum amount. If a Medicare recipient chooses a provider that does not accept the assignment and has higher fees, the patient is responsible for any additional costs, warns WebMD.

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