Does Medicare Cover Orthotics? What You Need to Know
Custom orthotics are special inserts made specifically for your feet. Unlike store-bought options, these are created from a mold of your foot and can cost $1,000 or more. They help control how your foot moves and provide support where you need it most.
Medicare does cover orthotics, but only when they're medically necessary. This usually means you need them to treat specific foot problems related to conditions like diabetes. Your doctor will need to prescribe them and explain why they're required for your care.
Let's look at what Medicare covers, how to qualify, and what you'll need to do to get coverage for your orthotics.
Key Takeaways
Orthotics include custom inserts or shoes and leg braces that provide additional support to people with medical conditions and others recovering from surgery or illness.
Medicare covers certain types of orthotics when deemed medically necessary. A doctor must prescribe the orthotics and confirm they’re medically necessary.
It is possible to receive orthotics coverage under Original Medicare, Medicare Advantage, and Medigap plans.
Does Medicare cover orthotics?
In short, yes. Medicare covers orthotics when deemed medically necessary for people with diabetes or conditions such as severe arthritis or severe foot issues. It can also cover orthotics for people who require Ankle Foot Orthoses (AFOs) and Knee Ankle Foot Orthoses (KAFOs).
What orthotics are covered?
Medicare beneficiaries with diabetes-related needs can receive one pair of custom-molded shoes and inserts or one pair of extra-depth shoes each year. Medicare can also cover two additional pairs of inserts for custom-molded shoes and three additional pairs of inserts for extra-depth shoes annually. In some cases, Medicare will cover shoe modifications instead of inserts.
However, not all orthotic devices are covered. The coverage depends on the specific medical conditions being treated and devices needed to support beneficiaries with those conditions.
Before Medicare will cover any orthotics, your doctor must prescribe them to confirm your eligibility. For diabetes-related orthotics specifically, the doctor treating your diabetes must certify that you need them. Coverage is available once per calendar year through Medicare Part B, as long as the devices are medically necessary for your condition.
For Medicare to cover your orthotics, they must also be purchased from a Medicare-approved supplier.
Original Medicare does not cover custom inserts designed to support the arches or correct foot problems. Medicare considers these primarily for comfort and not medically necessary.
How Medicare covers orthotics
Whether you are under Original Medicare or have coverage under Medicare Advantage or Medigap, it’s possible to get orthotics covered. Any out-of-pocket expenses depend on which plan you are enrolled in.
Original Medicare
Generally, Medicare coverage of orthotics falls under Medicare Part B, which covers braces that support your feet, ankles, and knees when medically necessary. These devices must be rigid or semi-rigid to qualify for coverage. They must support a weakened body part or help control movement in an area injured or affected by disease.
In some circumstances, Medicare Part A may cover your orthotics if you receive them during a hospital or Skilled Nursing Facility (SNF) stay. For example, if you need orthotics for treatment or rehabilitation during your stay, such as after foot or ankle surgery, they may be covered by Medicare Part A.
Medicare Advantage (Part C)
If you have a Medicare Advantage plan, it will provide at least the level of coverage as Original Medicare. Some plans might offer additional coverage or benefits that can reduce your share of costs. Contact your plan directly to learn about your specific coverage and costs.
Medicare Supplement (Medigap)
A Medicare Supplement plan reduces your share of costs for orthotics covered by Original Medicare. This includes help with your deductible, copayments, and coinsurance. How much your costs are reduced depends on which Medicare Supplement plan you have.
Orthotic costs with Medicare coverage
The out-of-pocket cost, meaning what you owe after your insurance pays its share, varies based on your Medicare coverage. This is because deductibles, coinsurance, and copays vary between Medicare coverage types and plans.
Original Medicare
When Medicare Part B covers your orthotic devices, you'll pay the annual Part B deductible ($257 in 2025) and 20% of the remaining cost for your orthotics.
If you receive orthotics during a hospital or skilled nursing facility stay under Part A, your costs are part of your inpatient charges. During your stay, you'll first pay the Part A deductible. After that, your daily costs increase the longer you stay:
For hospital stays: Your costs start at $419 per day on day 61 and increase to $838 per day after day 90. After 150 days, you pay all costs.
For skilled nursing facility stays: You pay nothing for days 1-20. Starting day 21, you pay $209.5 per day. After 100 days, you pay all costs.
Get a more detailed look at Part A and Part B in our guide on Medicare costs.
Medicare Advantage (Part C)
Your costs depend on your specific plan. Contact your plan to learn about copays and deductibles for orthotics.
Medicare Supplement (Medigap)
Your Medicare Supplement insurance plans may help pay your share of costs, including deductibles and the 20% coinsurance. The coverage amount varies by plan.
Medicare and orthotics coverage FAQs
What are orthotics?
Orthotics are special shoe inserts or shoes (like therapeutic shoes and orthopedic shoes) that help with foot and leg problems. Your doctor might recommend them to improve how your feet work and reduce pain. They can adjust how your foot meets the ground, support your arches, and cushion your steps. Orthotics also help keep your joints stable, especially if you have conditions like arthritis.
Leg braces (AFOs and KAFOs) are also included under orthotic devices. Braces are used to immobilize a body part post-surgery or injury, or provide support to a weakened or deformed part.
While you can buy simple shoe inserts over the counter, medical orthotics are different. These are prescribed by your doctor and made specifically for your feet. Your doctor will determine if you need them based on your foot problems and overall health.
What conditions might require orthotics?
A variety of conditions cause foot pain, swelling, and discomfort. Conditions that might require custom orthotic products include:
Foot pain and swelling during and after everyday activities, like walking and standing
Sharp heel pain, which may indicate plantar fasciitis
Flat feet or high arches that cause foot pain or inward rolling of your foot (overpronation)
Balance issues or falls due to collapsed arches
Uneven wear and tear on your shoes
A recent lower leg injury that affects the way you walk (gait abnormalities)
Foot complications from diabetes
What Are AFOs and KAFOs?
AFOs and KAFOs are types of orthotics. An Ankle Foot Orthosis (AFO) is a brace that supports your foot and ankle. Your doctor might recommend an AFO if you have foot drop, plantar fasciitis, ankle problems, or conditions like stroke or multiple sclerosis that affect how you walk.
A Knee Ankle Foot orthosis (KAFO) provides more support, covering from your foot up to your knee. Doctors often prescribe KAFOs for people who need help with leg weakness, knee stability, or walking.
Both types of braces can be custom made for your needs. They can also be purchased off the shelf. They work with or without shoes to help you walk better, stay balanced, and reduce pain. Your doctor or healthcare provider will help determine which type of brace is right for you.
Without Medicare coverage, orthotics cost a considerable amount of money. AFOs can range from $100 to $1,000, and KAFOs from $500 to $3,000. Medicaid may also help cover the costs of certain orthotics.
Does Medicare cover custom-made shoes?
Medicare Part B covers custom-made shoes for people with diabetes and severe diabetic foot disease. These shoes are made from a mold of your foot to provide the exact support you need.
To get Medicare coverage for custom shoes, you'll need:
A prescription from a doctor who accepts Medicare
A medical reason that shows why you need them
A Medicare-approved supplier
Medicare covers one pair of custom shoes and inserts per year. After meeting your Part B deductible, you'll pay 20% of the Medicare-approved cost.
Get personalized Medicare support
Want to learn more about how Medicare covers orthotics? Get in touch with one of our Medicare advisors, and they’ll help you understand how coverage works. They can also help you understand your Medicare options to choose the best coverage for your individual needs. Give us a call at 855-900-2427 or choose a time to talk.