The human foot has 26 bones and 33 joints, making them a complicated area of the body. Osteoarthritis, diabetes, and bunions are just some of the foot-related issues someone can encounter throughout their lifetime. Foot pain is also common in older adults and can cause limited mobility and other issues over time if it goes untreated. A podiatrist can help with a variety of foot-related issues, but will Medicare cover you seeing a podiatrist? What foot care health services and treatments will Medicare also cover?
Medicare may or may not pay for you to see a podiatrist. It depends on (1) what foot care services you see a podiatrist for, and (2) what kind of Medicare coverage you have. Medicare Part B covers some podiatry care if you have a need that is medically necessary, such as diabetes-related nerve damage or the treatment of foot injuries or diseases. It may also cover therapeutic shoes and inserts (or even shoe modifications) that a podiatrist recommends if you have diabetes and suffer from severe diabetic foot disease. If you have a Medicare Advantage (Part C) plan, your coverage and costs may be different. Talk with your plan provider, but you may be able to get more foot care benefits than with just Medicare Part B.
Medicare Part B doesn’t typically cover routine foot care, such as cutting or removal of corns and calluses, trimming of nails, or other hygienic maintenance, such as cleaning or soaking of the feet. If you see a podiatrist or other healthcare specialist for routine foot care, you’ll generally need to pay 100 percent of the costs. You may be able to get routine foot care covered if you have a Medicare Advantage plan, but again, you’ll need to check with your plan provider first.
Annual foot exams or treatments may be covered by Medicare Part B if you have diabetes-related nerve damage or need medically necessary treatments for a related foot injury or disease. Medicare Part B may cover medically necessary treatments for injuries or disease such as hammer toe, bunion deformities, and heel spurs. You will pay 20 percent of the Medicare-approved amount for the medically necessary treatment, and the Part B deductible will apply. However, for the treatment to be covered by Medicare Part B, you will also need a referral from your doctor. The amount you pay will be determined by whether your doctor accepts Medicare assignment. The amount you pay may also change based on other insurance you may have, how much your doctor charges, and the type of facility used for your treatments and testing. For example, in a hospital outpatient setting, you may also pay a copayment for medically necessary treatment. Again, your costs and coverage may be different with a Medicare Advantage plan, but when it comes to Medicare Part B, if your foot care treatment isn’t medically necessary and/or you do not receive a doctor’s referral, you will generally have to pay 100 percent of the costs.
