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MEDICARE

 

As of December 2014, the American Diabetes Association reported that roughly 30 million Americans suffer from diabetes. 60 to 70% of people with diabetes suffer from neuropathy, characterized as nerve damage and loss of sensation resulting in a loss of feeling. Unfortunately, diabetics with neuropathy of the feet are significantly more susceptible to skin changes, infections, calluses and ulcerations.

 

In order to circumvent these ailments and the potential of a lower limb amputation, Medicare statues were amended to cover certain therapeutic shoes, inserts and possible modifications for those patients that qualify based on their stated requirements. As opposed to traditional shoes, diabetic footwear is designed to prevent shearing, establish total contact with the bottom of the foot and maintain a greater depth.

 

Under the following conditions, Medicare covers diabetic shoes, inserts and/or modifications. These requirements are included within the Statement of Certifying Physician (SCP) letter which must be completed by a patient’s physician (either M.D. or D.O.) when submitting for fulfillment of a patient’s order.

 

Patient has been diagnosed with diabetes and has one or more of the following (in one or both feet):

-Partial or complete amputation(s) of foot or part of one’s foot

-A history of foot ulceration

-Pre-ulcerative callus formation

-Peripheral neuropathy with sign of callus formation

-Poor circulation

-Foot deformity

 

Additionally:

-Patient is being treated by the physician under a comprehensive plan for his/her diabetes and must have visited with his or her Primary Care Physician within 6 months, and the SCP must have been signed within 3 months of order fulfillment

-Patient needs therapeutic shoes and/or inserts due to his or her diabetes

 

To learn if you are eligible for diabetic shoes and inserts, contact a footcare specialist in your area by visiting our Locations page and finding an Anodyne provider near you.