Medicare Therapeutic Shoes: Getting the Help You Need

Footwear is an important tool for helping keep feet safe and healthy for diabetic individuals. Here at Austin Foot & Ankle Specialists, we are pleased to provide access to various shoe suppliers to assist our patients who live with diabetes. Find out more about Medicare coverage and prescription information so you can get the shoes you need to protect your feet from dangerous conditions.

Medicare Assistance for Diabetic Shoes

Shoes at Austin Foot & Ankle SpecialistsIn an effort to prevent foot ulcers in people with diabetes who are at risk, Medicare will help pay for therapeutic shoes. For those who qualify, Medicare will pay 80 percent of the allowed amount for one pair of shoes and up to three pairs of molded innersoles per year. Most secondary insurers will help pay the other 20 percent. These discounts are instrumental in helping you get the footwear you need to prevent diabetic foot ulcers and other conditions at an affordable price.

Who Qualifies for Assistance?

Not all individuals are eligible to participate in the Medicare program. To qualify, you must be under a comprehensive diabetes treatment plan and have one or more of the following qualifications:

  • history of partial or complete amputation of the foot
  • history of previous foot ulceration
  • history of pre-ulcerative callus
  • peripheral neuropathy with evidence of callus formation
  • foot deformity
  • poor circulation

Who Does Not Qualify for Government Assistance?

People with diabetes who do not have any of the above conditions do not qualify. Unfortunately, it is not enough to simply have the disease. If this applies to you, and you do not meet the qualification criteria, our office can still assist you by creating a diabetic foot care plan centered on protection and early detection for issues that are a threat to your health and safety.

What Paperwork Is Required for the Medicare Assistance?

The physician treating you for your diabetes must certify that you: 1) have diabetes, 2) have one or more of the foot problems previously mentioned, 3) are under a comprehensive diabetes treatment plan, and 4) need the special shoes. Medicare has a form for this certification and you will also need a prescription for the shoes. We can provide assistance for this process.

Who Prescribes the Shoes?

A prescription is required from a podiatrist or physician who knows how to fit shoes and inserts for people with diabetes. The prescription should indicate a particular type of footwear, such as shoes, inserts, or modifications. Our foot doctors can write the prescription and will ensure that it has all the information necessary for you to take advantage of this program.

Who Supplies the Shoes?

In accordance with the Medicare program, the footwear must be fitted and furnished by a podiatrist or other qualified individual, such as a pedorthist, orthotist, or prosthetist. As with the prescription for the diabetic footwear, we are able to assist you with this as well.

What Do You Receive From the Program?

Coverage is limited to one of the following per calendar year:

  • One pair of off-the-shelf extra-depth shoes and three additional pairs of special inserts that your podiatrist will select for you. Extra-depth shoes have room to accommodate innersoles or orthotics.
  • One pair of off-the-shelf extra-depth shoes including a modification, and two additional pairs of inserts.
  • One pair of custom-molded shoes and two additional pairs of special inserts.

Medicare Therapeutic Shoes in Austin, TX

Austin Foot and Ankle Specialists currently provide access to over five different diabetic shoe suppliers where qualified patients may pick from a variety of shoes and styles. Patients will be measured and fitted for their shoes in our office. Please call (512) 328-8900, if you have any questions, require forms to bring to your primary care physician, or would like to schedule an appointment (which you can also do online).

Dr. Shine John, DPM, FACFAS
Podiatric Physician, Surgeon, Specialist at Austin Foot and Ankle Specialists