DIABETIC SHOES

Proper Shoes are a Must for those with Diabetes
Diabetic shoes are a medical device and as such should be provided by a qualified individual, primarily defined as a podiatrist, orthotist, pedorthist, or pharmacist. Sports and Wellness meets those requirements.

We will measure and evaluate your feet, fit the shoes and inserts, and follow-up with you to make sure that your shoes are accomplishing your desired and prescribed goals.

Medicare Part B: Therapeutic Shoe Coverage

About one in four individuals with diabetes develop foot problems as a result of the disease. Poor circulation and neuropathy (nerve damage leading to a lack of sensation) can lead to serious foot problems such as ulcers and infection. To help people care for their feet, Medicare Part B and Insurance offers coverage for therapeutic shoes and inserts for those who qualify. 

What is the Medicare Part B and Insurance Diabetic Footwear benefit?

Insurance partially covers the approved cost of medically-necessary shoes or inserts. Patients may qualify for one of the following benefits: 
  1. One pair of depth-inlay shoes and three pairs of inserts every calendar year
  2. One pair of custom-molded shoes, including inserts, and two additional inserts for patients who cannot wear depth-inlay shoes due to a foot deformity
  3. Separate inserts or shoe modifications for some patients with milder foot problems
Medicare pays 80% of the approved cost for footwear and the full cost of fitting the shoes. The patient is responsible for the remaining 20% of the cost as well as any applicable deductible. Secondary insurance may assist with co-payment or deductible. 
How to qualify for therapeutic footwear coverage
 To qualify for the therapeutic footwear benefit, patients must meet three conditions:
  1. Have Diabetes. 
  2. Patient has been treated by an M.D. or D.O under a comprehensive diabetes care plan in the last 6 months and needs therapeutic shoes and/or inserts because of Diabetes.
  3. Has one or more of the following conditions in one or both feet:
  • History of partial or complete foot amputation
  • History of previous foot ulceration
  • History of pre-ulcerative callus
  • Peripheral neuropathy with evidence of callus formation 
  • Poor circulation
  • Foot deformity
  • You must have had an examination within the past 6 months. The examination must document the underlying condition and specific need for the shoes.
What do I do Next?
A Doctor must fill out a statement certifying medical necessity verifying the patients meets the above criteria and write a prescription specifying the type of footwear the patient needs. 

Contact your Primary Care Physician or Podiatrist for discussion of your qualification for Therapeutic Shoes and Inserts. 
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