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Does Medicare cover routine foot care?

En español | No, but routine foot care may be different things to different people.

Medicare considers routine foot care to be the removal of calluses and corns; cutting, trimming or removing nails; and hygienic or preventive maintenance, such as cleaning or soaking your feet. It won’t cover these services but will cover some medically necessary foot treatments that a doctor prescribes.

People with diabetes, who are prone to nerve damage that can affect feet and legs, are eligible for extra foot-related coverage. 

When does Medicare cover foot care?

Diseases, injuries and other medical conditions that affect feet and lower legs are among the types of foot care that Medicare covers. But a doctor or a podiatrist must document the diagnosis and that the treatment is medically necessary. In this case, Medicare may cover:

  • Foot problems from conditions such as cancer, chronic kidney disease, diabetes, multiple sclerosis or vein inflammation related to blood clots.
  • Toenail clipping in a doctor’s or a podiatrist’s office if doing it yourself could be hazardous to your health.

Does Medicare cover foot care for diabetes?

Yes, Medicare provides extra foot-related coverage for diabetics. That’s because they may develop neuropathy, which is nerve damage in the feet and legs, or peripheral artery disease, which reduces blood flow to the feet.

These problems increase the risk of ulcers and infections that may eventually lead to amputation. If you have diabetes-related lower leg nerve damage that can increase the risk of limb loss, Medicare covers foot exams every six months.

But the coverage is conditional. Medicare will pay for that exam only if you haven't seen a foot care professional for another reason between visits.

Shoes and inserts. Because diabetic nerve damage can also cause changes in the shape of your feet and toes, Medicare will cover one pair of therapeutic shoes and the accompanying orthotic inserts each calendar year for people with severe diabetic foot disease.

While a podiatrist or other doctor must prescribe the shoes and inserts, and you can purchase them directly from these sources, you can also purchase them from a medically licensed:

  • Orthotist, who makes and fits braces and splints for foot injuries or disorders.
  • Pedorthist, who modifies and fits therapeutic footwear or orthotic support devices.
  • Prosthetist, who makes artificial limbs for people with disabilities.

These medical professionals must be enrolled in Medicare, so it’s important to check with the provider before you make the purchases.

Peripheral neuropathy treatment. If you’ve been prescribed medication for peripheral neuropathy that can develop from diabetes, checking the formulary for your Part D drug plan will be especially important. If you’re signed up for a Medicare Advantage plan, you also should look at your plan’s formulary.

For the most part, you can’t change plans at any time, except under certain circumstances. If your prescriptions aren’t covered, you have some options, including requesting a formulary exception from the plan and working with your doctor to see if another drug that is listed in your plan’s formulary also will work for you.

Keep in mind

Therapeutic shoes, eligible foot exams for people with diabetic nerve damage, and other qualified foot care from a podiatrist are covered under Medicare Part B after you pay the annual Part B deductible, which is $233 in 2022 and $226 in 2023. You then have to pay 20 percent of the Medicare-approved costs if your doctor or other provider accepts Medicare assignment.

You can buy a Medicare supplement policy, also called Medigap, to cover the 20 percent Part B coinsurance costs. Or you can choose to have coverage from a private Medicare Advantage plan instead of original Medicare. It must cover the same foot-related expenses but has different deductibles and copayments.

Some Medicare Advantage plans have benefits for special needs, such as specific plans focusing on diabetes. These may include additional coverage for foot care, so check with your plan on what it covers.

Updated November 8, 2022

     

        


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