Does Medicare Cover Podiatry Services?
Did you know that one-third of older adults have some sort of foot pain or foot-related issue? Overlooking problems with your feet can lead to some serious complications and mobility issues. Foot-related problems can be symptoms of other conditions like diabetes. You can also experience foot-related issues by wearing shoes that don’t fit properly.
Seeing a podiatrist, a doctor that specializes in foot problems, is important if you need foot care. Medicare covers podiatrist exams or treatment under a couple circumstances:
You have diabetes-related nerve damage
You need medically necessary treatment for foot injuries or conditions
In this article, we’ll discuss the specifics of Medicare coverage for podiatry and what services Medicare can pay for.
Key takeaways:
Medicare covers exams and treatment for podiatry (foot-related issues) if you have diabetes-related nerve damage or you need medically necessary treatment for foot injuries or conditions.
If you have Original Medicare only, you are responsible for 20% of the costs of the service you need for foot care.
Medicare Advantage plans provide the same coverage for podiatry, but out of pocket charges vary between insurance providers.
What is podiatry?
A podiatrist is a medical professional who treats health conditions related to the foot, ankle, and sometimes leg. They specialize in podiatry, which is a branch of medicine all about feet and ankles. A podiatrist can:
Use X-rays, MRI scans, and lab tests to assess issues with your feet
Develop a treatment plan for foot issues
Prescribe medication, order physical therapy, or recommend surgery
Perform surgery to correct bunion deformities, hammertoe, and tendon issues
Fit a person for an orthotic device (devices like foot pads or heel inserts that align your joints and ease pressure)
Manage chronic conditions that affect feet, like diabetes and arthritis
Help educate and set plans for patients to prevent future foot complications
Seeking advice from a podiatrist can improve your mobility, relieve pain, and address any concerns you have about your feet and ankles.
What does Medicare cover for podiatry?
Medicare covers podiatry if you have diabetes-related complications with your feet, or you need medically necessary treatment for any injuries or foot conditions. These injuries or conditions can include:
Hammer toe
Bunion deformities
Heel spurs
Plantar fasciitis
Arthritis
Ankle sprains and bone fractures due to osteoporosis
Severe ingrown toenails
Medicare also covers X-rays or exams that are needed to diagnose a foot condition, injury, or condition.
Does Medicare cover podiatry for plantar fasciitis?
Yes, Medicare covers podiatry for plantar fasciitis. This is a common condition that causes pain in the bottom of the foot and occurs when the plantar fascia (tissue that connects the heel bone to the toes) gets inflamed or irritated. Running, standing for long periods of time, and wearing footwear that doesn’t fit well can all cause plantar fasciitis.
A podiatrist may recommend treating plantar fasciitis with physical therapy, medication, or other methods to reduce inflammation. Medicare covers physical therapy sessions as long as your doctor says you need the treatment. If you need medication, Part D will be responsible for covering your prescriptions.
How much does Medicare cover for podiatry?
If you have Original Medicare and no Medigap plan, you’ll be responsible for 20% of the Medicare-approved amount for podiatry services, once you’ve met your Part B deductible (which is $240 in 2024). If you have a Medigap plan (also called a Medicare Supplement plan), it will pay for some of your out-of-pocket costs.
Medicare Advantage covers the same services as Original Medicare, but your out-of-pocket costs can vary depending on the specific policy you have. The best way to know how much you’ll pay is to contact your insurance company and medical provider’s billing department. Your provider’s billing department can also help you get any necessary prior authorizations before receiving treatment.
What does Medicare not cover for foot care?
In most cases, Medicare won’t cover routine foot care. This includes grooming services such as:
Cutting and/or removing corns and calluses
Trimming and clipping nails
Hygienic services like soaking your feet
There are exceptions to this rule in certain medical situations, however. If you need your nails cut for a surgical procedure, for treating warts on your foot, or for treating an infected toenail, Medicare won’t charge you. Otherwise, you’ll need to cover 100% of a routine foot service.
Medicare and diabetic foot care coverage
If you have diabetes-related foot problems, Medicare will cover treatment supplies, including therapeutic shoes and inserts.
Medicare covers many supplies and services for diabetes, including insulin and insulin related supplies, medications, and preventive screenings.
How else Medicare can help with mobility issues
If you have foot issues that affect your mobility, you can also use mobility devices to get help moving around. Medicare covers mobility devices like canes, walkers, and wheelchairs when they are medically necessary. Talk to your healthcare provider to see what all your options are for treating mobility issues and making movement easier.
Curious about what else your Medicare plan covers? Our licensed Medicare Advisors can guide you through the ins and outs of your coverage so you get the most value out of your insurance. Call 855-900-2427 or schedule a chat today for free, personalized advice.