Making foot care a priority as we age is especially important to maintain an active, healthy lifestyle. You may be eligible to receive foot care coverage if you’re enrolled in Medicare. The amount out of pocket and coverage benefits depends on if it is routine foot care (podiatry) or medically necessary foot care.
ROUTINE FOOT CARE
Routine podiatry, or foot care, generally refers to day-to-day maintenance and care. Such as; trimming or clipping toenails, removing calluses or corns, and soaking feet to prevent future issues. Routine podiatry services usually aren't covered by Original Medicare or Medicare Advantage because they are defined as things you can do at home or without trained aid. For these reasons you will be responsible for paying the full amount for these services, unless you’re told otherwise by Medicare or your podiatrist with a referral from your primary care physician. Always check before receiving care.
Diabetic Foot Care
People with diabetes can develop many different foot problems, even minor problems can lead to serious complications. Diabetes can cause nerve damage in your lower legs, increasing the risk of amputation. Original Medicare can cover an ANNUAL FOOT EXAM with a podiatrist. These exams are covered as long as you have a diabetes-related lower leg nerve damage that raises the risk of amputation and haven’t seen a foot doctor since your last annual foot exam.
This exam is usually covered by Medicare Part B and you’d be responsible for 20% of the Medicare-approved amount plus your Part B deductible. If you receive care in a hospital outpatient setting, you would owe a copayment.
Medically Necessary foot care
If podiatry is medically needed Original Medicare will generally cover exams, diagnosis, and treatment for foot injuries and diseases such as; hammer toe, bunions, and heel spurs.
Original Medicare will usually pay 80 % of the federally approved amount for medically necessary foot care, leaving you to pay 20% out of pocket. You will owe a copay if you receive the treatment in a hospital outpatient setting.
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Some Medicare Advantage plans may offer additional coverage, though this is specific to each plan. If you’re interested in seeing your options, email us today to set up a meeting and let us help you decide what works best for you.
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