What Do Medicaid and Medicare Cover for Foot Care?
- Medicaid covers foot care in some states, though coverage levels may vary. Medicare, however, does cover medically necessary foot care in all states. Learn more about how Medicaid and Medicare pay for podiatry services.
While Medicare does not cover routine foot care such as treating corns or calluses, Medicare does cover foot care when it’s medically necessary to treat injuries or diseases. Medicare also covers foot care related to the treatment of diabetes.
Medicaid, which is different and separate from Medicare, covers foot care in some states. Because Medicaid is administered differently in each state, however, some states may not cover foot care through Medicaid.
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When Will Medicaid Cover Podiatry?
Medicaid considers podiatry services to be an optional Medicaid benefit, which means that some states may not cover routine foot care through Medicaid.
According to the Kaiser Family Foundation, 40 states provide Medicaid coverage for podiatry services (foot care). Coverage varies by state, with some states covering services such as two visits to a podiatrist per month, some states covering routine foot care once every 6 months, and some states not covering foot care at all. Some states may require a copay or coinsurance for Medicaid-covered foot care, while some other states may cover the full cost.
Be sure to check with your state Medicaid agency to find out what foot care services are covered in your state.
Federal law requires all states to cover certain mandatory Medicaid benefits such as inpatient hospital services and lab and X-ray services. Foot care isn’t considered a mandatory Medicaid benefit.
How Often Does Medicare Pay for Foot Care?
Foot care that may be covered by Medicare includes:
- Foot exams following an injury or as necessary because of a disease
- Treatment of hammer toes, heel spurs and bunion deformities
- Treatment for diabetes-related nerve damage
- Durable medical equipment (DME) for foot care
Medicare also covers durable medical equipment, which can include items related to foot care such as:
- Walking boots
- Foot or ankle casts and braces
- Hammer toe crest pads
- Toe spacers
- Prosthetic limbs
Medicare Covers Foot Care for Diabetes
If you have diabetes-related lower leg nerve damage that may increase the risk of limb loss, Medicare will cover an annual foot exam as well as treatment for foot ulcers, calluses and toenail management, based on your foot exam results.
Medicare also covers the fitting and furnishing of a pair of custom-molded shoes (along with two pairs of inserts) or a pair of extra-depth shoes (with three pairs of inserts) once per calendar year.
How Much Does Foot Care Cost on Medicare?
Foot care that is covered by Medicare will be typically covered by Medicare Part B and by all Medicare Advantage (Part C) plans.
- Medicare Part B is optional and provides coverage for outpatient care like doctor’s appointments as well as durable medical equipment.
- Medicare Advantage plans are sold by private insurance companies. By law, these plans are required to provide all of the same basic benefits offered by Medicare Part A and Part B, so any foot care covered by Part B will also be covered by any Medicare Advantage plan.
Medicare Part B requires a standard monthly premium of $148.50 per month in 2021 (some higher income earners may pay more).
Part B also includes an annual deductible of $203 per year in 2021. Once you meet your deductible, you’re typically responsible for 20% of the remaining balance for covered foot care. Many beneficiaries may use a Medicare Supplement Insurance (Medigap) plan to help cover this Medicare coinsurance cost. Medicare Supplement plans are different from Medicare Advantage plans, and you can’t have both types of plans at the same time.
Because Medicare Advantage plans are sold by private insurers, the monthly premiums will vary. Some Medicare Advantage plans may offer $0 monthly premiums. Medicare Advantage plans also contain their own deductibles and cost-sharing requirements.
