In 1995, Congress amended Medicare statutes to provide partial reimbursement for extra-depth shoes and shoe inserts for qualifying Medicare Part B patients with diabetes. The Centers for Disease Control has estimated that 86,000 lower limb amputations due to diabetes occur annually – and experts agree that most are preventable with appropriate footwear that is properly fit.

How do I qualify?

The physician (M.D. or D.O.) who manages your systemic diabetes is called the certifying physician .  The certifying physician must state the following:

1. You have diabetes mellitus

2. You exhibit one or more of the conditions which Medicare describes as an at-risk factor:

1. History of partial or complete amputation of the foot
2. History of previous foot ulceration
3. History of pre-ulcerative callus
4. Peripheral neuropathy with evidence of callus formation
5. Foot deformity
6. Poor circulation

 

3. You are being treated under a comprehensive plan of care for your diabetes and that you would benefit from therapeutic shoes and/or inserts.  

•  History of partial or complete amputation of the foot

•  History of previous foot ulceration

•  History of pre-ulcerative callus

•  Peripheral neuropathy with evidence of callus formation

•  Foot deformity

•  Poor circulation

What is reimbursable?

Within a given calendar year (January-December), a qualifying patient can receive an allotment from Medicare for one pair of extra depth shoes and three pairs of inserts .

 

How much do I have to pay?

The Medicare will reimburse a portion of the amount it designates as “allowable,” with the patient, or supplementary insurance, responsible for paying the dispenser/supplier the remainder of the total payment amount.

 

Where do I go to obtain the shoes?

Please use our provider finder service to locate a Dr. Comfort provider in your area.**Link**