Does Medicare Cover Podiatry?

Yes, Medicare does cover podiatry services that are medically necessary to treat foot or ankle conditions. Medicare Part B (Medical Insurance) covers podiatry services, which include diagnosis and treatment of foot injuries, diseases, and conditions such as heel spurs, hammertoes, and plantar fasciitis.

However, there are some limitations and requirements to keep in mind. For example, Medicare may only cover podiatry services if they are performed by a podiatrist or other qualified health care professional who is enrolled in Medicare. Additionally, some podiatry services may require a referral from your primary care physician, and certain services may have coverage limits or co-payments.

If you have questions about Medicare coverage for podiatry services, you may want to consult with your healthcare provider or contact Medicare directly for more information.

WHAT ARE SOME SERVICES THAT ARE NOT COVERED BY MEDICARE?

While Medicare does cover most medically necessary podiatry services, there are some services that are generally not covered. Some examples of podiatry services that are not covered by Medicare include:

1. Routine foot care: This includes services such as cutting or trimming of toenails, callus removal, and routine foot inspections. These services are typically considered to be maintenance and preventive in nature and are not covered by Medicare.
2. Orthopedic shoes or inserts: While Medicare may cover some types of durable medical equipment (DME), such as braces or prosthetic devices, orthopedic shoes or inserts are generally not covered unless they are an integral part of a leg brace.
3. Services provided by non-Medicare providers: Medicare may only cover podiatry services that are provided by a podiatrist or other qualified healthcare provider who is enrolled in Medicare. Services provided by non-Medicare providers may not be covered.
4. Cosmetic foot surgery: Podiatry services that are solely for cosmetic purposes are not covered by Medicare.

It’s important to note that there may be exceptions to these general guidelines, and coverage can vary based on your specific situation and medical needs. You can contact Medicare directly or speak with your healthcare provider to learn more about what podiatry services are covered under your Medicare plan.

Does Medicare Supplements Plans Cover Podiatry?

Yes, Medicare Supplement (also known as Medigap) plans may cover podiatry services that are covered by Medicare. Medigap plans are designed to help cover some of the out-of-pocket costs that Original Medicare (Part A and Part B) doesn’t cover, such as deductibles, coinsurance, and copayments.

If Medicare covers a particular podiatry service, then a Medigap plan can help cover the out-of-pocket costs associated with that service. For example, if you have a Medigap plan and you receive a covered podiatry service, such as treatment for a foot injury or disease, your Medigap plan may help cover the Medicare coinsurance or deductible for that service.

Do Medicare Advantage Plans Cover Podiatry?

Yes, Medicare Advantage plans (also known as Medicare Part C) cover podiatry services that are considered medically necessary to diagnose or treat foot or ankle conditions. Medicare Advantage plans are offered by private insurance companies that contract with Medicare to provide all the benefits of Original Medicare (Part A and Part B) and often include additional benefits, such as prescription drug coverage, dental, and vision coverage.

Like Original Medicare, Medicare Advantage plans cover podiatry services that are considered medically necessary, such as treatment for foot injuries or diseases, and may include services such as foot exams, foot care, and corrective shoes or inserts. However, the specific services covered may vary depending on the plan, and some plans may require a referral from a primary care physician or prior authorization.

If you have a Medicare Advantage plan and are considering podiatry services, it’s a good idea to check with your insurance company to see what specific services are covered and what out-of-pocket costs you may be responsible for. It’s also important to understand the plan’s network of providers and any requirements for seeing a podiatrist within that network.