Katie Gregory assisting client with diabetic/therapeutic shoe selection.
Written by: Katie Gregory, DME sales specialist of Diabetes/Therapeutic Shoes at Agnesian Health Shoppe
When I am working with individuals who are looking for the best pair of shoes for their specific medical needs, there are certain questions I am generally asked. Here are the answers to the two more commonly-asked questions.
What percentage does Medicare cover?
Medicare typically covers 80 percent, but I always call the insurance company to verify coverage.
Medicare Part B (medical insurance) covers the furnishing and fitting of one pair of extra-depth shoes and inserts each calendar year. Medicare also covers three pairs of inserts each calendar year for extra-depth shoes.
All people with Part B who have diabetes and severe diabetic foot disease are covered. Your primary care provider must certify that you need therapeutic shoes or inserts. A podiatrist or other qualified provider can refer for these items.
Medicare will only cover your therapeutic shoes if your doctors and suppliers are enrolled in Medicare. Providers and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your providers or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them.
How do I get the shoes through insurance?
Insurance might cover if you have type 1 diabetes or type 2 diabetes. It requires a face-to-face appointment with your primary care provider who cares for your diabetes.
The provider will do a foot exam, and if you meet the criteria, a script will be sent to the Agnesian Health Shoppe. While a podiatrist can do the foot exam, it’s the primary care provider that orders the shoes.