Mobility Aids- Orthopediic Shoes are Covered by Medicare ????

(Filed under mobility aids, orthopedic shoes )

Here is a good question that I hear a lot about……Will Medicare Cover Orthopedic Shoes?

First of all lets just clarify some things. There are numerous types of orthopedic shoes as well as many types of covered products for leg braces. If by chance they are a necessity for a persons daily existence then Medicare will cover :

Brands and types
Oxfords
High tops
Depth inlays
Custom shoes for non diabetics

And if they are also a medical necessity for the proper functioning of the brace, Medicare will cover:Heel replacements
Sole replacements
Shoe transfers

Also make note that patients with partial amputations to the feet can have their prosthetic shoes covered if they are an important part of the prosthesis.

Here are some of the restrictions that apply to coverage :The bill for the shoe and the brace must originate from the same supplier.

The treating physician who is handling the patient needs to follow proper protocol by signing and dating the detailed order for the prosthesis.
This order also must be kept on file with the actual supplier in the event if it needs to be made available to the Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC).
It is important to note that Shoes, any inserts, and modifications for diabetic patients are covered under Medicare and its Diabetic Footwear policy.

Another good question is how much will you have to pay for orthopedic shoes?
You will pay 20% of the Medicare approved amount under Medicare Part B.
Also you must have to pay $135 deductible for any Medicare Part B services and supplies before Medicare begins to pay its share. And this amount may even be higher if the doctor,supplier, or health care provider does not accept assignment.
We really cannot stress enough how important it is for your supplier to be participating in the Medicare program. If a supplier of your durable medical equipment ,denoted as DME, refuses to accept assignment the charge you may be required to pay could be huge !! And you just may have to pay the complete bill when you receive your DME.

(Topics related mobility aids, orthopedic shoes)

Leave a Reply

Your email address will not be published. Required fields are marked *