How Does Medicare Cover Treatment from your Podiatrist?

Fortunately, Medicare covers treatment of foot/feet problems whenever medically necessary.

Normal Foot Problems for Seniors 

Seniors, all in all, are in more danger of foot issues because they are more likely to have other health conditions which impact the health of the feet. For example, diabetes and joint inflammation can put you in danger of certain foot issues. 

Toenail overgrowth, nerve harm, hammertoes, bunions, tarsal passage disorder, and Achilles tendonitis are quite common for seniors. 

A podiatrist, or foot care pro, can treat and enable you to deal with these issues. Medicare considers podiatry services to be necessary whenever they are to treat a specific ailment that causes pain or problems walking.

More routine foot care services, however, such as cutting nails, corns, or calluses are typically not services that will be Medicare approved. 

How Medicare Covers Essential Podiatry 

When other health conditions affect the health of your feet, Medicare may cover the treatment. How Medicare pays will depend on whether you need an inpatient or outpatient service. 

Medicare Part B covers outpatient services. This includes things that both you and I would consider to be outpatient services, like doctor visits and lab testing. However, Part B also covers more expensive outpatient services like surgeries, diagnostic imaging, and urgent care.

Part B has a yearly deductible of $185 that you should initially meet before Medicare will pay anything. When you have paid $185 out-of-pocket on Medicare Part B-expenses, Medicare will pay 80 percent of your Part B costs for the remainder of the calendar year. The remaining 20 percent will be your obligation. This is called your Part B coinsurance.

In the event that you need a surgical procedure to treat a genuine foot condition, Medicare Part A may pay for surgery and hospital care. Whenever a surgery is performed in an inpatient hospital, Part A will help to provide your semi-private room and food.

Part A has a deductible of $1,364 that you will encounter if you are admitted to the hospital. Then Part A covers your initial 60 days in the hospital and also the initial 20 days in a skilled nursing facility (SNF) if you were to need one while you are recuperating.

Investigate Medicare Plans to Cover the Gaps

If you are concerned about paying for Medicare’s deductibles, copays, and coinsurance, then you may want to look into supplemental coverage. Private insurance carriers offer alternative Medicare plans that help to lower out-of-pocket expenses and offer additional advantages. There are two main types of coverage: Medigap plans and Medicare Advantage. 

Part D Coverage 

Some foot conditions are treatable by the utilization of various medications. Medicare Part D covers your retail physician-prescribed medicines that you would ordinarily pick up yourself at a local pharmacy. 

Part D plans are sold by private insurance carriers, not Medicare itself. Each Part D plan is organized with 4 stages during which you pay certain costs. The main differences between Part D plans are their costs, monthly premiums and drug formularies. 

Each Insurance carrier can choose their Part D plans' premiums, copays, deductibles, formularies as long as they remain within Medicare's rules and guidelines for Part D. Like Parts A and B, Part D requires you to share in some of the costs in the form of deductibles and also prescription copayments or coinsurance.

All Part D plans are required to offer the inclusion of at least two prescriptions in each treatment class. This will ensure that if you develop a new health condition after you have already enrolled in Part D, your doctor will have some medications on the formulary to choose from when prescribing.

Medicare for Diabetic Patients 

Since diabetes is a sickness that can result in problems within the feet, Medicare will cover a couple of additional podiatry services for diabetes patients. Diabetes is known to cause poor blood flow, nerve harm, and neuropathy. 

Medicare Part B may cover things, such as restorative shoes, insoles and a foot test every six months to prevent further problems. 

Corrective shoes and insoles are offered under Part B if certain prerequisites are met. The inclusive prerequisites are as per the following: 

Your specialist has confirmed diabetes and you are being treated for it. Your doctor must also document that you have one of the following accompanying issue: a deformed foot, history of calluses or ulcers, amputation of at least part of your foot, insufficient blood flow to your feet or peripheral neuropathy with calluses.

It’s possible that Dr. Petkov will prescribe you therapeutic shoes or inserts and Medicare will cover one pair every 12 months if they are deemed medically necessary.


You Might Also Enjoy...

Your Podiatrist is One Text Away!

On average, people tend to send 5 times more texts than phone calls. One of the most preferred ways of direct communication is texting. This is why we have decided to offer this feature to all of Premier Podiatry's new and existing patients.

Get Your Feet Ready for Summer

With the warm months and beach weather in New Jersey ahead of us, here are some essential tips from Clifton, NJ podiatrist Dr. Velimir Petkov to get your feet ready for summer.