Does Medicare cover podiatry services?

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Foot care is one of the areas that Medicare does not cover unless the procedure, service, or item is medically necessary.

Routine foot care includes cutting back corns or calluses, clipping nails, treating flat foot, and other non-emergency care for the feet.

Medicare will cover podiatrists, foot exams, or treatment for people with diabetes-related nerve damage. It will also cover medically necessary treatment for foot injuries or diseases, such as hammer toe, bunion deformities, and heel spurs.

To qualify for coverage, you must have been seen by a medical doctor or osteopath at least six months before your first podiatrist treatment. The podiatrist will attest to this and you will have provided this documentation before they submit the claim to Medicare.

For covered services, you will pay 20 percent of the Medicare-approved amount and the Part B deductible applies. If you are receiving outpatient treatment, you will also owe a copayment.

Patients receiving care for diabetes-related foot disease can be covered for custom-molded shoes or extra-depth shoes once per year as long as they are prescribed by your podiatrist. Medicare will cover two pairs of inserts for the custom-molded shoes and three pairs of inserts for the extra-depth shoes per calendar year.

Other Non-Covered Services

Like foot care, routine services and items for dental, hearing, and vision are left out of the coverage for Medicare Part A and Part B. Only medically necessary procedures are covered and no eyeglasses, hearing aids, or dentures are covered.

Medicare Advantage is the answer for those looking for coverage in these areas. Find a plan that offers dental, vision, and/or hearing in addition to the standard Part A and Part B coverage. These Part C plans are offered by private companies approved by Medicare to provide your Part A and Part B coverage. They often carry prescription drug coverage as well, which you normally have to pay for separately as Part D.

To qualify for Medicare Advantage, you must be enrolled in Medicare Part A and Part B and live within the plan’s service area. The time to switch from Original Medicare to a Medicare Advantage plan comes every year during Open Enrollment (also known as the Annual Election Period). This is from October 15 to December 7. During this time, you can make changes to your plan. If you are already enrolled in a Medicare Advantage plan, you will be notified with the Annual Notice of Change in the fall of each year for any changes to your plan. You have the chance to switch to a different Medicare Advantage plan or back to Original Medicare from January 1 to March 31.

To learn more about what Medicare will and will not cover, contact Bobby Brock Insurance today!

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Justin Brock

President & CEO of Bobby Brock Insurance