Medicare’s Diabetic Shoe Benefit
In May 1993, congress passed the Therapeutic Shoe Bill (TSB). Since then, Medicare Part B (Medical Insurance) provides reimbursement of therapeutic shoes, inserts and modifications for those living with diabetes who meet specified qualifying requirements.
Coverage is for anyone with Medicare Part B (or other qualified insurance) who has diabetes, has appropriate documentation from a qualified physician, and:
. Previous amputation of the foot, or part of either foot, orHistory of ulcers, or
. History of pre-ulcerative calluses, or
. Diabetic Neuropathy with evidence of Callus formation, orFoot deformity, or
. Poor blood circulation
Consult a qualified expert or Medicare program representative for more details.
What’s Covered?
Medicare allows one pair of extra-depth shoes per calendar year. For qualifying patients, Medicare will also cover three pairs of inserts each calendar year. Some shoe modifications are also covered but would replace a pair of inserts.
Note: Medicare only covers diabetic shoes and inserts if the doctor is enrolled in Medicare. If not enrolled, Medicare won’t pay the claims submitted by them. Doctors and suppliers must meet guidelines to enroll and stay enrolled in Medicare.
Diabetic footwear can:
Reduce shock and shear. One way to keep diabetic feet safe is to reduce the amount of shock (vertical pressure) and shear (horizontal friction) experienced. Diabetic socks and shoes are designed to reduce these respective forces.
Limit motion of joints. Controlling the range of motion for certain joints in the foot can help to decrease inflammation, relieve pain, and result in a more stable and functional foot.
Relieve areas of excessive pressure. Too much pressure in concentrated areas can result in ulceration (skin breakdown). Diabetic footwear can redistribute forces in a more natural manner, thereby reducing the risk of issues developing.
Accommodate, stabilize and support deformities. Many deformities need to be stabilized to both avoid further damage and relieve pain when diabetes is in the picture. We can help to protect the foot by making sure you have the shoes you need.
Why can’t I just wear comfortable, regular shoes if I have diabetic neuropathy or other foot problems related to diabetes?
The simple answer to this question is another question: why take that risk? Many of the foot problems caused by diabetes can turn into more serious health complications, but they can also be prevented. It is just common sense to take measures that promote better foot health and overall health, i.e., wearing the right footwear. This is especially true when this footwear is often covered by insurance.