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Foot health is a major concern for people with diabetes. Nerve damage and poor circulation can make even small foot problems turn into serious complications. To help prevent issues, Medicare provides coverage for specialized footwear designed for diabetics. If you qualify, you may be eligible to receive diabetic shoes covered by Medicare, but how much of the cost does it actually cover?

Many people assume that Medicare will pay for their diabetic shoes in full, but coverage depends on several factors, including your specific Medicare plan, medical necessity, and where you get your shoes. Understanding what’s covered—and what’s not—can help you avoid unexpected expenses while getting the right footwear to protect your feet.

What Exactly Does Medicare Cover?

Medicare recognizes diabetic shoes as therapeutic footwear, which falls under Medicare Part B. This benefit is designed specifically to help prevent diabetes-related foot complications.

Medicare typically covers one of these two options each calendar year:

• One pair of custom-molded shoes plus two additional pairs of inserts.

• One pair of depth-inlay shoes (also known as extra-depth shoes) along with three pairs of therapeutic inserts.

These shoes and inserts help prevent pressure sores, calluses, and ulcers by providing proper cushioning, depth, and protection.

Does Medicare Cover the Entire Cost?

Medicare generally pays for 80% of the approved amount for diabetic shoes. The remaining 20% is usually your responsibility, plus any applicable annual deductibles. However, many beneficiaries have secondary or supplemental insurance that covers this remaining 20%, often resulting in no out-of-pocket costs.

If you have additional coverage through Medicaid, Medicare Advantage, or a supplemental plan like Medigap, your diabetic shoes could indeed be fully covered.

It's important to confirm your specific coverage details, as policies vary between individuals and plans.

Who Qualifies for Diabetic Shoes Covered by Medicare?

Not every individual with diabetes automatically qualifies for Medicare coverage of diabetic shoes. Specific criteria must be met:

You must:

• Be diagnosed with diabetes.

• Be actively receiving care for diabetes under a comprehensive treatment plan.

• Have at least one of the following foot conditions:

• Partial or complete foot amputation.

• Previous foot ulcers.

• Calluses at risk of turning into ulcers.

• Foot deformities (like hammertoes, bunions, Charcot foot).

• Poor circulation (peripheral artery disease).

• Diabetic neuropathy (nerve damage causing loss of sensation).

Your doctor must certify your medical need, and a prescription for therapeutic shoes is also required from a podiatrist or another qualified medical professional.  

How to Ensure Medicare Pays for Your Diabetic Shoes

To guarantee Medicare coverage for your diabetic shoes, specific procedures must be carefully followed:

Step 1: Obtain Necessary Documents

Medicare requires three essential documents from two medical professionals:

• Certificate of Medical Necessity (CMN): Your primary doctor (MD or DO) must certify your need for diabetic shoes due to diabetes-related foot conditions.

• Shoe Prescription: Usually from a podiatrist or foot-care specialist. Your primary care doctor, nurse practitioner, or a qualified specialist can also write this prescription.

• Proof of Purchase from Medicare-Approved Supplier: Your shoes must be obtained from a supplier that can directly bill Medicare.

Without these specific documents, Medicare will not cover your shoes, leaving you responsible for the full cost.

Step 2: Choose a Medicare-Approved Supplier

Medicare only covers diabetic shoes purchased from Medicare-approved suppliers. This supplier should ideally offer direct billing to Medicare, eliminating upfront costs and paperwork hassles.

Choosing the right supplier ensures you won't accidentally purchase shoes from an ineligible vendor, preventing out-of-pocket expenses and reimbursement complications.

Step 3: Get Professionally Fitted

A proper fit is mandatory for Medicare coverage. Medicare requires diabetic footwear to be fitted by a licensed shoe fitter, certified pedorthist, or qualified podiatrist. These experts ensure the shoes fit properly, are comfortable, and effectively prevent foot complications.

Medicare will not pay for diabetic shoes purchased from general shoe stores without a certified professional fitting.

What Else Should You Consider?

Medicare provides great support for diabetic footwear, but you still need to be proactive about your foot health. Here are some additional considerations:

• Quality and Fit: Always choose footwear that provides ample space, cushioning, and support. Even with Medicare coverage, comfort and quality should always be your priority.

• Regular Foot Checks: Inspect your feet daily for cuts, redness, swelling, or calluses. Address any issues immediately.

• Annual Coverage Timing: Plan your yearly diabetic shoe benefit strategically, making sure you get a new pair of shoes each year to maintain optimal foot health.

What Happens if Medicare Denies Coverage for Diabetic Shoes?

Sometimes Medicare may deny your claim for diabetic shoes, often due to missing paperwork, documentation errors, or using a non-approved supplier. If this happens, review your Explanation of Benefits (EOB) to identify the exact reason for denial and determine the necessary corrections.

In many cases, you can appeal by submitting the correct documentation or working directly with a Medicare-approved supplier to streamline the process. Taking the time to ensure all documents and requirements are correct beforehand can help prevent future denials and make the process smoother.  

The Bottom Line

Medicare covers 80% of the approved cost of diabetic shoes, but there are important eligibility requirements, including documentation, proper fittings, and purchasing from approved suppliers. If you have supplemental insurance, you may have your diabetic shoes completely covered.

Understanding Medicare coverage helps you protect your feet—and your wallet. By following Medicare’s guidelines, you can greatly reduce your costs, and in many cases, obtain your therapeutic shoes without any out-of-pocket expenses.

Need Diabetic Shoes Covered by Medicare? No Cost Shoes Can Help!

Navigating Medicare’s diabetic shoe coverage doesn't have to be complicated. No Cost Shoes, a division of Quantum Medical Supply, simplifies the entire process by directly handling Medicare billing—eliminating upfront costs and tedious reimbursement paperwork. We coordinate directly with your doctor, providing all the necessary documentation to ensure you meet Medicare’s requirements.  

Additionally, a licensed shoe fitter will visit your home to personally assist you in choosing diabetic shoes that offer comfort and the ideal fit. Let No Cost Shoes help you get diabetic shoes covered by Medicare quickly and easily. Contact us today to find out if you're eligible for full coverage!