Does Medicare Cover Podiatry? 5 Fast Facts

Did you know the average person walks 100,000 miles over a lifetime? It should be no wonder foot problems cost the U.S. $3.5 billion in health care costs every year. 

The excellent news is podiatrists can help. Podiatrists are doctors who specialize in problems of the foot and ankle.

If you’re dealing with a foot problem, you may be wondering: does Medicare cover podiatry? Today, in this Senior Affair article, we’re answering that question and more. 

Ready to finally get the care you need to get back on your feet? Then keep reading for everything you need to know about podiatry, routine foot care, and what Medicare covers.

Does Medicare Cover Podiatry?

The first thing to understand about Medicare and podiatry is the difference between podiatry and routine foot care.

Podiatry requires a specialized physician to perform medical foot care. Meanwhile, routine foot care includes filing down calluses, treating flat feet, and clipping nails. 

Medicare tends to cover medically necessary treatments performed by a specialist. Medicare only covers routine foot care in some instances. 

Medicare Coverage For Routine Foot Care

Routine foot care you receive that’s unrelated to an underlying foot condition is routine care. Medicare does not cover most types of routine foot care. 

Medicare may cover the care if routine foot care is a part of managing or treating a medically necessary foot condition. However, a podiatrist must perform the treatment in both in-patient and out-patient settings. 

Medicare Coverage For Podiatric Care

You can receive coverage for in-patient and out-patient podiatric care under Medicare Part A and Part B, respectively. 

For the former, you must see a physician at a Medicare-approved health care facility. If you choose to visit a specialist’s office or receive care in your home, Medicare Part B will cover the care.

Medicare Part B provides coverage for:

  • Diabetes-related nerve damage
  • Foot injuries
  • Foot diseases, including hammertoe, bunion deformities, and heel spurs

Remember that your doctor must deem any out-patient podiatric services medically necessary to qualify for Part B Medicare coverage. You must also have seen a doctor at least six months before your first podiatric treatment and have documents to prove it. 

Once you submit the required documentation, Medicare Part B will cover any foot exams and treatments you need. 

You’ll pay 20% coinsurance once you meet your Medicare Part B deductible for in-patient treatments. Out-patient treatments like those in a doctor’s office or at your home will also require a copay. 

Want to Contact an Agent about Medicare?

So, does Medicare cover podiatry? The answer to this question depends on defining podiatry correctly. 

Medicare does cover medically necessary treatments for foot injuries and diseases and nerve damage related to a diabetes diagnosis. Medicare doesn’t cover routine foot care for bunions, flat feet, and other non-medically necessary foot services.

Now you should know if Medicare covers your foot condition, injury, or diabetes-related nerve damage.

Contact a licensed insurance agent today.

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