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Get Diabetic Shoes Through Medicare: How to Know If You Qualify

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Every 1.2 seconds someone with diabetes develops a diabetic foot ulcer. This can lead to tissue death, amputation, sepsis, and death.

Having special diabetic shoes contribute to healthy feet. They decrease pressure points and blisters. Diabetic Shoes are considered durable medical equipment (DME) and require a prescription from your provider.

You can call your insurance provider and ask about your benefits for diabetic shoes. Alternatively, our patient care coordinator Beata can help you out with a complimentary benefits check. Private Insurance and Medicare have provisions to pay for DME which our New Jersey podiatrist office is authorized to dispense. Talk with your insurance provider to determine how much they cover for diabetic shoes.

How can you determine if you qualify for coverage of your diabetic shoes through Medicare? Read on below.

Importance of Diabetic Foot Care

Why should I worry about my feet if I have diabetes?

High blood sugar in the bloodstream causes the lining of ALL blood vessels to become cracked like a dry riverbed. Fats in the blood, like cholesterol, stick in those cracks and then build up. This causes blockage of blood flow.

Diabetes also affects nerve function. This can result in decreased sensation in parts of the body.

The feet are of great concern. They bear the weight of the whole body which presses on blood vessels. It can be difficult to check your feet for sores.

If you develop a blister, scrape, cut, or get something in your foot, you may not know if you lack normal sensation. Potential decreased blood flow to the feet slows healing. This may result in severe infection, death of tissue, and may lead to amputations.

Prevention of Diabetic Foot Injury and Infection

By following this list about foot care, you can decrease your chance of problems:

  • Look at the top and bottom of your feet and between your toes every day
  • Call your doctor if you see cuts, blisters, ingrown toenails, or sores
  • Notify your doctor of changes in color, shape, or different pain or feelings in your feet
  • Have a practitioner treat corns or calluses
  • Ask for help if you are unable to safely trim your nails
  • Wash your feet every day and dry them completely, especially between the toes
  • Don’t walk barefoot in areas that may be unsafe, hot, or cold
  • Avoid hot water bottles, heating pads, or electric blankets.
  • Test bathwater to ensure proper temperature
  • Stay physically active
  • Wear clean socks and shoes that are comfortable, supportive, and do not rub your feet

Foot care can be a matter of life or death for a person with diabetes.

What are Diabetic Shoes?

All shoes are not created equal. To qualify as a diabetic shoe, certain standards must be met:

  • Protective, soft interior without protruding stitches
  • Non-binding, stretchable uppers conform to the foot and prevent pressure points
  • Extra depth provides a pressure-free fit that can accommodate thick orthotic inserts
  • Deep toe box allows toes to move freely and not press on each other
  • Lightweight, cushioned soles help with mobility, stability, and reduce the impact on the foot

Custom orthotics have many purposes. They can relieve pressure points on your feet that could become sores.

Will Medicare Pay for Diabetic Shoes?

Each calendar year, Medicare Part B (Medical Insurance) covers either:

  • Custom molded shoes and inserts and possibly 2 additional pair of inserts, or
  • Extra-depth shoes and possibly 3 pair of inserts

Medicare also covers shoe modifications in place of inserts.

What you need to know about Medicare payment:

  • If the manufacturer accepts the assignment, the Part B deductible applies, and you pay 20% of the Medicare-approved amount
  • Your physician and shoe supplier must be enrolled and participating in Medicare
  • The specific cost may depend on other insurance you have, physician charge, whether your doctor accepts assignment, type of facility, and where you get your shoes
  • A qualified provider must prescribe the shoes

You must make sure that Medicare covers the services requested before ordering shoes. If they do not, you must pay the entire bill.

Are You Ready for Great Foot Care?

Our site provides information about state-of-the-art foot care. You will find information about treatments, advanced technologies, and upcoming events. We also assist you in finding needed resources such as diabetic shoes.

Chat with our office staff today online for answers about payment options, appointments, and directions to Clifton, NJ or Wayne, NJ offices.

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