Medicare Part B can cover therapeutic shoes and inserts for people who meet its diabetes-related foot-care criteria. Diabetes alone does not establish coverage for any shoe you choose. The treating clinician's certification, an appropriate order and a qualified supplier are central to the benefit.
What the benefit can include
For an eligible person, the annual benefit generally allows either one pair of extra-depth shoes with three pairs of inserts, or one pair of custom-molded shoes, including inserts, with two additional pairs. Custom-molded shoes require a foot deformity that prevents use of depth-inlay shoes. Certain insert substitutions or shoe modifications may be covered under the applicable rules.
Follow the certification and fitting process
- Ask the doctor treating your diabetes to evaluate and certify the qualifying need.
- Obtain the required order from a podiatrist or other qualified doctor.
- Use a qualified furnishing provider enrolled in Medicare.
- Confirm fitting arrangements and the exact shoe and insert quantities.
- Ask how adjustments and any later replacement request are handled.
Check your expected payment
After the Part B deductible, the usual share is 20% of the Medicare-approved amount when the supplier accepts assignment. Ask about assignment before ordering and request an itemized estimate. Other insurance can affect your responsibility, while optional or noncovered purchases may cost more.
Do not assume a retail receipt or an ordinary comfort-shoe recommendation satisfies the therapeutic footwear requirements. Keep certification, order and delivery records with your benefit information.
Medicare Advantage or a denied claim
With Medicare Advantage, confirm the supplier network and authorization requirements through the plan. If a claim is denied, ask whether the issue is eligibility, documentation, quantities or supplier billing. Request the written decision and appeal instructions.
This is an insurance guide, not a recommendation for a particular shoe or a substitute for professional evaluation of a foot problem. The clinician and fitting provider should determine suitability.
Related coverage questions
- A Medicare Medical Claim Was Denied: What to Do Next
- Diabetic Eye Exams and Medicare: Annual Coverage and Costs
- Walkers and Medicare: Check the Order and Supplier