Medicare Coverage Disclosure
IMPORTANT NOTICE:
Medicare Part B coverage for therapeutic shoes and custom-molded inserts is strictly limited. Medicare only provides coverage for these items when they are medically necessary for the treatment of Diabetes Mellitus accompanied by specific qualifying foot complications.
When Medicare DOES NOT Cover Orthotics
- Routine Foot Pain: Conditions like Metatarsalgia, heel spurs, bunions, and general arch pain are typically excluded from coverage for inserts.
- Over-the-Counter Inserts: Anything you can buy at a pharmacy or retail store is never covered.
- Standalone Shoes: Even "orthopedic shoes" are not covered if they are just for support or comfort.
Medicare typically considers foot orthotics and orthopedic shoes as "supportive devices" rather than "medical necessities" for non-diabetic conditions. Consequently, reimbursement is generally unavailable for the conditions listed below.
Common Non-Covered Conditions
- Metatarsalgia (Ball-of-foot pain)
- Posterior Tibial Tendon Dysfunction (PTTD)
- Plantar Fasciitis / Heel Pain
- Severe Flat Foot (Pes Planus)
- Chronic Achilles Tendonitis
- Arthritic Foot Deformities
Alternative Options for Care
We provide specialized solutions for all patients, regardless of Medicare eligibility. Non-covered services may be handled via:
- HSA / FSA: Custom orthotics are a qualified medical expense under most Health Savings and Flexible Spending Accounts.
- Private Insurance: Some commercial plans offer benefits that Medicare does not.
- Self-Pay: We offer professional evaluations and custom-constructed inserts using advanced 3D scanning.
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