5000 Bee Cave Road
Suite 202
Austin, TX 78746
(512) 328-8900
fax (512) 328-8903
Medicare Therapeutic Shoe Program
Medicare Therapeutic Shoe Program
In 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.
Who Qualifies?
To qualify, you must be under a comprehensive diabetes treatment plan and have one or more of the following:
- 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?
People with diabetes who do not have one of the above conditions. It is not enough to just have diabetes.
What paperwork is required?
The physician treating you for your diabetes must certify that you have diabetes, that you have one or more of the foot problems just mentioned, that you are under a comprehensive diabetes treatment plan, and that you need the special shoes. Medicare has a form for this certification. You will also need a prescription for the shoes.
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.
Who supplies the shoes?
The footwear must be fitted and furnished by a podiatrist or other qualified individual, such as a pedorthist, orthotist, or prosthetist.
What do you get?
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.
Austin Foot and Ankle Specialists currently provide access to over 5 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 to make an appointment, if you have any questions, or require forms to bring to your primary care Physician.