Medicare covers 80% of the approved amount for therapeutic diabetic shoes after you’ve met your annual Part B deductible. You pay the remaining 20% as coinsurance. The benefit covers one pair of shoes and multiple pairs of inserts per calendar year, but only if you have diabetes with specific foot complications.
What Medicare Pays and What You Owe
Diabetic shoes fall under Medicare Part B, which means the standard cost-sharing rules apply. Once you’ve met the Part B deductible ($257 in 2025), Medicare pays 80% of whatever it has approved as the allowable charge for the footwear. You’re responsible for the other 20%. If your provider accepts Medicare assignment, they’ve agreed to charge no more than the Medicare-approved amount, so your 20% coinsurance is based on that fixed figure rather than the provider’s retail price.
If you have a Medigap (Medicare Supplement) plan, it may cover part or all of your 20% coinsurance. Medicare Advantage plans must cover at least what Original Medicare covers, though out-of-pocket costs can vary by plan.
What Footwear Is Covered
Medicare distinguishes between two types of therapeutic shoes for people with diabetes: depth shoes and custom-molded shoes. Which one you qualify for depends on the severity of your foot condition.
Depth shoes (also called extra-depth shoes) are the more common option. These look like regular shoes but have a removable insole that creates at least 3/16 of an inch of extra interior space. That added room accommodates custom or customized inserts designed for your feet. They come in standard sizes and at least three widths, and they must have a proper closure (laces, straps, or velcro) and be made of leather or equally durable material.
Custom-molded shoes are built over a positive model of your individual foot. They’re reserved for people whose foot deformities are too severe for a depth shoe to accommodate. Like depth shoes, they must have removable inserts and a shoe closure, and be made from leather or comparable material.
Annual Limits on Shoes and Inserts
Medicare caps the benefit at one of the following per calendar year:
- If you get depth shoes: one pair of depth shoes plus three pairs of custom inserts (not counting the standard removable inserts that come with the shoes).
- If you get custom-molded shoes: one pair of custom-molded shoes (including the inserts provided with them) plus two additional pairs of inserts.
You can get shoe modifications instead of inserts in some cases, but the overall annual limit still applies. The coverage resets each calendar year, so if your inserts wear down or your foot shape changes, you can get new ones the following January.
Who Qualifies for Coverage
Not everyone with diabetes automatically qualifies. Medicare requires that you have diabetes along with at least one of these serious foot conditions:
- History of partial or complete foot amputation
- History of a foot ulcer
- Pre-ulcerative calluses
- Peripheral neuropathy with callus formation
- Foot deformity
- Poor circulation in the feet
These conditions reflect feet that are at genuine risk of breakdown, infection, or further amputation. If you have diabetes but healthy feet with no complications, the benefit doesn’t apply.
The Certification Process
Getting Medicare to pay for diabetic shoes involves two different providers, and the paperwork matters. Your certifying physician, who must be an M.D. or D.O. managing your diabetes under a comprehensive care plan, fills out a formal statement confirming that you have diabetes, that you have one or more qualifying foot conditions, and that you need therapeutic shoes because of your diabetes. This physician signs and dates the certification and provides their National Provider Identifier (NPI).
A separate provider, typically a podiatrist or other qualified practitioner, writes the actual prescription for the specific type of shoe and inserts. The prescribing provider and the certifying physician cannot be the same person unless the certifying physician is also the one treating the foot condition. This two-provider requirement exists to prevent unnecessary claims and is a common reason denials happen, so make sure both roles are clearly filled before you order shoes.
Where to Get the Shoes
You must get your diabetic shoes from a supplier enrolled in Medicare. This could be a podiatrist’s office that dispenses footwear, a pedorthist (a specialist in therapeutic shoe fitting), an orthotist, or a prosthetist. Some pharmacies and durable medical equipment suppliers also carry them. The key requirement is that the supplier has a Medicare supplier number. If you buy shoes from a provider who isn’t enrolled in Medicare, you’ll pay the full cost yourself with no reimbursement.
Before your appointment, confirm that the supplier accepts Medicare assignment. Suppliers who accept assignment agree to bill Medicare directly and charge you only the 20% coinsurance plus any unmet deductible. Suppliers who don’t accept assignment can charge more than the Medicare-approved amount, and you’d owe the difference on top of your coinsurance.
Keeping Your Claim From Being Denied
The most common reasons Medicare denies diabetic shoe claims are documentation problems rather than medical ones. Make sure you have the signed physician certification on file before the shoes are dispensed. The certification must specifically name which qualifying foot condition you have. If the form is incomplete, unsigned, or missing the physician’s NPI, the claim will be rejected.
Timing also matters. The certifying physician’s statement should be completed within the same treatment period as the shoe fitting. If your certification is months old and doesn’t reflect your current condition, it may not hold up. Keep copies of all paperwork, including the certification, the prescription, and the supplier’s invoice, in case you need to appeal a denial.