Medicare covers diabetic shoes under Part B, but only if you meet specific medical and documentation requirements
Yes, Medicare covers diabetic shoes — but not for everyone, and not without paperwork. Medicare Part B pays for therapeutic shoes and inserts if you have diabetes and your doctor documents that you need them to prevent foot complications. The shoes must be prescribed by a podiatrist or other may have access to doctor, and you must buy them from an approved supplier. Medicare pays 80% of the approved amount after you meet your Part B deductible; you pay the remaining 20%.
The catch is that Medicare has strict rules about who qualifies and what counts as a covered shoe. A regular shoe from a regular store will not be covered, even if you have diabetes. The shoe must be specially made or modified for your feet, and your doctor must document a medical reason why you need it.
Key Takeaways
- Medicare Part B covers diabetic shoes only when prescribed by a doctor and bought from a Medicare-approved supplier.
- Your doctor must document that you have diabetes and a foot condition that makes therapeutic shoes medically necessary.
- Medicare covers one pair of shoes and up to three pairs of inserts per year, paying 80% of the approved amount after your deductible.
- You will need a prescription from your doctor and proof that you are seeing a doctor for your diabetes care at least once per year.
- Shoes bought online or from regular shoe stores are not covered, even if they are labeled as diabetic shoes.
Who qualifies for Medicare coverage of diabetic shoes
To may have access to, you must have diabetes and at least one of these foot conditions: a history of foot ulcers, calluses, or corns caused by diabetes; nerve damage in your feet from diabetes; poor circulation in your feet; or a foot deformity related to diabetes. Your doctor must document that you have one of these conditions and that therapeutic shoes are medically necessary to prevent further damage.
You also must be under the care of a doctor for your diabetes — not just diagnosed with it years ago. Medicare requires that you see a doctor at least once per year for diabetes management. If you have not seen a doctor for diabetes in over a year, you will need to schedule an appointment and get a new prescription before the shoes will be covered.
If you have a foot ulcer or severe foot damage, your doctor may refer you to a podiatrist or orthopedist instead of a general doctor. That specialist can also write the prescription for diabetic shoes.
What Medicare covers and what you pay
Medicare Part B covers one pair of therapeutic shoes and up to three pairs of inserts per calendar year. The shoes must be custom-made or specially modified for your feet — they cannot be off-the-shelf shoes, even if they are marketed as diabetic shoes. Inserts can be custom-made or prefabricated, depending on your foot condition.
Medicare pays 80% of the approved amount for the shoes and inserts after you have met your Part B deductible for the year. If you have not met your deductible, you pay the full approved amount until you do, then Medicare begins paying 80%. You are responsible for the remaining 20% of the approved amount, plus any amount the supplier charges above what Medicare approves.
The approved amount varies by region and supplier. A supplier can charge more than the approved amount, but you are only responsible for the 20% coinsurance on the approved amount — not on the overage. Ask the supplier what the Medicare-approved amount is before you buy the shoes.
How to get a prescription and find an approved supplier
Start by scheduling an appointment with your primary care doctor or endocrinologist. Tell them you are interested in diabetic shoes and ask whether your foot condition qualifies. If your doctor agrees, they will write a prescription that includes your diagnosis, the reason you need therapeutic shoes, and the type of shoe or insert you need.
Once you have the prescription, you need to buy the shoes from a Medicare-approved supplier. Not all shoe stores are approved, and not all approved suppliers carry all types of shoes. You can search for approved suppliers on the Medicare website by entering your ZIP code, or you can call 1-800-MEDICARE to ask for a list of suppliers near you.
Bring your prescription and Medicare card to the supplier. The supplier will measure your feet, discuss your needs, and order or fit the shoes. The supplier handles the paperwork with Medicare — you do not submit a claim yourself. After Medicare approves the order, the supplier will tell you what your 20% coinsurance costs.
What documentation your doctor needs to provide
Your doctor's prescription must include specific information for Medicare to cover the shoes. The prescription should state that you have diabetes, describe the foot condition that makes therapeutic shoes necessary, and confirm that you are under active care for your diabetes. Your doctor should also note whether the shoes need to be custom-made or whether prefabricated therapeutic shoes will work.
Medicare may also ask for documentation of your diabetes care — such as records showing you have seen a doctor for diabetes within the past year, or lab results like an A1C test. This is why it is important to keep up with regular diabetes appointments. If you have not seen a doctor in over a year, you will need to schedule a visit and get a new prescription before the shoes can be covered.
What happens if you need shoes more than once per year
Medicare covers one pair of shoes and up to three pairs of inserts per calendar year. If you wear out a pair of shoes before the year ends, you will have to pay out of pocket for a replacement, or wait until January 1st when your annual benefit resets.
If your foot condition changes — for example, if you develop a new ulcer or your foot deformity worsens — your doctor can write a new prescription and you may be able to get another pair before the year ends. This is not automatic; your doctor must document that your medical condition has changed and that you need new shoes as a result. Contact your supplier or call Medicare to ask whether a change in your condition allows you to get shoes before your annual limit is reached.
Shoes and inserts not covered by Medicare
Regular shoes from shoe stores, even if they are labeled as diabetic shoes or orthopedic shoes, are not covered. Shoes you buy online are not covered. Shoe inserts you buy over the counter are not covered. Socks, foot creams, or other foot care products are not covered. Only shoes and inserts prescribed by a doctor and bought from a Medicare-approved supplier count toward your benefit.
If you have supplemental insurance (Medigap) or a Medicare Advantage plan, check your plan documents to see whether they cover any of the 20% coinsurance. Some plans do; others do not. Call your plan's customer service number to ask before you buy the shoes.
Frequently Asked Questions
Do I need a new prescription every year to get diabetic shoes?
Not necessarily. If your foot condition has not changed, your doctor may be able to write a prescription that covers multiple pairs over time. However, Medicare requires that you be under active care for your diabetes, which usually means seeing a doctor at least once per year. If you have not seen a doctor in over a year, you will need a new appointment and a new prescription before you can get shoes.
What if my doctor says I need diabetic shoes but my Medicare Advantage plan denies them?
Medicare Advantage plans must cover the same diabetic shoe benefit as Original Medicare, but they may have different suppliers or approval processes. If your plan denies the shoes, ask your doctor to appeal the decision or contact the plan's customer service line to ask why. You can also file a complaint with Medicare if you believe the plan is not following Medicare rules.
Can I get diabetic shoes if I have not seen a doctor for diabetes in two years?
No. Medicare requires that you be under active care for your diabetes to may have access to for diabetic shoes. You will need to schedule an appointment with a doctor, get your diabetes managed, and then ask for a prescription for shoes. Once you have an active relationship with a doctor, you can move forward with getting the shoes covered.
Will Medicare cover custom orthotics or shoe inserts separately from shoes?
Yes. If you only need inserts and not new shoes, Medicare can cover up to three pairs of inserts per year. Your doctor must still prescribe them and document that they are medically necessary. You buy them from a Medicare-approved supplier, and Medicare pays 80% of the approved amount after your deductible.
What if the Medicare-approved amount is less than what the supplier charges?
You are responsible for 20% of the Medicare-approved amount, not 20% of what the supplier charges. If the supplier charges more than Medicare approves, you do not pay the difference — only the 20% coinsurance on the approved amount. Always ask the supplier what the Medicare-approved amount is before you order the shoes.