If I have Medicare, am I covered for foot care?

As a basic rule, Medicare does not pay for routine foot care. Routine care includes cutting or removal of corns, calluses, trimming of nails, routine hygiene and any other services performed in the absence of a localized illness or injury. Medicare does not pay for treatment of flat feet.

Medicare will cover foot care for those who QUALIFY under Medicare part B.  The following are possible health conditions that may warrant Medicare coverage of foot care:

• Diabetes –services will include a foot exam that is comprised of sensory testing, examination of the foot structure, evaluation of the need for special footwear, vascular status and skin integrity. These services may be performed every 6 months
• Diagnosis of Peripheral Neuropathy
• Peripheral Vascular Disease
• Ulcers, wounds, or infections of the feet
• Warts
• Fungal infection of the toenail (mycotic nail)
• Surgeries and follow-up care

*This is not intended to be a comprehensive list but includes some the most common conditions that might justify coverage. Please consult with your physician. Care determinations may be based on whether or not you have an underlying medical problem that is severe enough that you would be at risk if someone other than a professional provides your foot care.

Medicare provides coverage for depth-inlay shoes, custom-molded shoes, and shoe inserts for people with diabetes who QUALIFY under Medicare Part B. Medicare will pay for 80% of the payment amount allowed. The patient is responsible for 20% of the total payment and possibly more if the provider does not accept Medicare assignment.

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