Nearly 10 percent of the U.S. population has diabetes, but for those over the age of 65, that number doubles to 20 percent. Fortunately, Medicare covers diabetic shoes and inserts for beneficiaries living with diabetes.
Why are diabetic shoes important?
When sugar builds up in the bloodstream as it does with diabetes, it damages tiny blood vessels throughout the body. This includes nerves that control feeling in the hands and feet. Because of this, many people with diabetes experience diabetic neuropathy, which most often presents as pain, numbness, or tingling in the hands, arms, and especially the feet.
These specialized, therapeutic shoes help improve circulation and offer additional cushion and protection for people with diabetes. The numbness that occurs with diabetic neuropathy often means people with diabetes may be unaware of wounds on their feet. If these wounds are not caught early and treated, they can become infected and, in severe cases, lead to amputation.
Diabetic shoes are considered durable medical equipment (DME). They’re covered by Medicare Part B as long as they are prescribed by a Medicare-approved doctor and provided by a Medicare-approved supplier.
Original Medicare covers one pair of diabetic shoes per year as well as three pairs of inserts. Medicare will pay for 80 percent of the cost of the shoes or inserts. You will be responsible for a 20 percent coinsurance as well as the Part B deductible.
Medicare also covers one foot exam every six months for beneficiaries with diabetic neuropathy. If you need more frequent visits to monitor or heal foot wounds with a foot care specialist, Medicare may cover these as well.
In order to be eligible for diabetic shoes, you need to have at least one of the following documented by your doctor in your medical records:
- Full or partial foot amputation
- Foot deformity
- Poor blood circulation
- History of foot sores, wounds, calluses, or ulcers
- Diabetic neuropathy
If you think you need diabetic shoes, talk to your general practitioner or podiatrist.
Coverage of diabetic shoes may differ if you have a Medicare Advantage plan, so call your insurer directly to ask what’s covered for your diabetes management.