Does Medicare Cover Foot Care?
Medicare doesn’t cover routine foot care such as trimming nails, removing calluses or cleaning feet. But Medicare Part B will pay 80 percent of the cost of services related to a foot injury or disease like diabetes. For medically necessary foot care, you will owe 20 percent and the Part B deductible, plus a copayment if you are an outpatient in a hospital.
When Will Medicare Cover Foot Care?
You must have an injury or serious foot condition in order for your foot care to be covered under Medicare Part B, which is insurance for medically necessary outpatient procedures.
- Hammer toe
- A deformity in which the toe is bent in a claw-like way. It often results from wearing shoes that are too tight or fit poorly.
- A deformity in which the big toe points inward. It is caused by wearing tight shoes and can heavily affect your foot’s function.
- Heel spurs
- A bony growth on your heel that can cause a lot of pain. It usually results from inflammation.
Even though Medicare will cover medically necessary foot care, it doesn’t mean that Medicare will cover any foot condition that’s diagnosed by a doctor.
Treatment of issues that are not considered serious medical problems, like flat foot, will not be covered. Supportive devices for your feet, like orthopedic shoes or inserts, are also not covered unless you have severe diabetic foot disease.
Does Medicare Cover Routine Foot Care?
Medicare does not cover routine foot care because those services are rarely considered medically necessary. Routine treatments include nail care, hygienic services and treatment of corns and calluses. Routine care can be beneficial to your health, but it is typically considered to be preventive.
However, there are some conditions that might make routine foot care a medically necessary service, which then qualifies you for coverage. These conditions include alcoholism, pernicious anemia, Buerger’s disease and other ailments that can severely affect your feet. Most diseases that affect the metabolic, neurologic or vascular systems could also make routine foot care medically necessary.
Check with your doctor or health care provider if you think you have a condition that might impact your feet enough to deem routine care medically necessary.
Does Medicare Advantage (Part C) Cover More Foot Care?
Even though Medicare will not cover routine foot care in most cases, taking care of your feet is important to your overall health, and it can prevent problems that could negatively affect your quality of life.
Your doctor may recommend services that Original Medicare doesn’t cover. A Medicare Advantage plan, also known as Part C, may offer extra coverage for routine foot care.
Advantage plans cover everything included in Original Medicare on top of additional benefits. If you are interested in more foot care coverage, check for a plan that includes these services.
Medicare Foot Care Coverage If You Have Diabetes
Medicare will cover foot care, exams and treatment if you have severe diabetic foot disease. This condition stems from diabetic neuropathy, which is nerve damage that occurs as a result of diabetes.
According to the Centers for Disease Control and Prevention, about half of people with diabetes have some form of neuropathy. While this can occur anywhere on your body, the legs and feet are the most commonly affected areas.
Diabetic neuropathy causes loss of feeling in your feet, which can lead to ulcers, infection and the need for amputation. The potential for serious outcomes is the reason why Medicare will cover foot care as a medically necessary service if you have severe diabetes. You’ll receive a bill for 20 percent of the Medicare-approved costs, and the Part B deductible applies as well.
Medicare might also cover orthotics and shoe inserts if you have diabetes to alleviate foot pain and provide support.
10 Cited Research Articles
- Centers for Disease Control and Prevention. (2021, May 7). Diabetes and Your Feet. Retrieved from https://www.cdc.gov/diabetes/library/features/healthy-feet.html
- U.S. National Library of Medicine. (2020, July 25). Hammer Toe. Retrieved from https://medlineplus.gov/ency/article/001235.htm
- Harvard Medical School. (2020, July 7). What to Do About Bunions. Retrieved from https://www.health.harvard.edu/diseases-and-conditions/what-to-do-about-bunions
- National Institute of Diabetes and Digestive and Kidney Diseases. (2017, January). Diabetes and Foot Problems. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems
- U.S. Centers for Medicare & Medicaid Services. (2017). Foot Care Coverage Guidelines. Retrieved from https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnmattersarticles/downloads/se1113.pdf
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Foot Care. Retrieved from https://www.medicare.gov/coverage/foot-care
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Foot Care (Routine). Retrieved from https://www.medicare.gov/coverage/foot-care-routine
- University of Kentucky. (n.d.). Heel Spur. Retrieved from https://ukhealthcare.uky.edu/orthopaedic-surgery-sports-medicine/conditions/foot-ankle/heel-spur
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Therapeutic Shoes & Inserts. Retrieved from https://www.medicare.gov/coverage/therapeutic-shoes-inserts
- U.S. Centers for Medicare & Medicaid Services. (n.d.). What Part B Covers. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-b-covers