Medicare covers 80% of the approved amount for diabetic shoes after you meet your Part B deductible. You pay the remaining 20% coinsurance. The Part B deductible in 2025 is $257, and once you’ve met it for the year, Medicare picks up its share of the cost for therapeutic footwear. The benefit renews every calendar year.
What Medicare Actually Covers
Medicare Part B covers therapeutic shoes for people with diabetes under one of two options each calendar year. You can get either a pair of custom-molded shoes (built from a cast of your foot) with two additional pairs of inserts, or a pair of extra-depth shoes with three pairs of inserts. Shoe modifications, like rocker soles or wedge adjustments, can substitute for inserts if your provider determines they’re needed.
The distinction between the two shoe types matters because it affects your insert allowance. Custom-molded shoes already conform closely to your foot, so Medicare allows fewer replacement inserts. Extra-depth shoes are roomier and rely more heavily on inserts for fit and protection, so you get an extra pair.
What You’ll Pay Out of Pocket
After your annual Part B deductible, you’re responsible for 20% of the Medicare-approved amount for the shoes and inserts. The approved amount is what Medicare considers a reasonable charge, not necessarily the retail price. If your supplier accepts Medicare assignment, they agree to charge no more than the approved amount. If they don’t accept assignment, you could owe more.
For a rough estimate: Medicare-approved amounts for extra-depth diabetic shoes typically fall in the range of $100 to $150 per pair, meaning your 20% share would be roughly $20 to $30 for the shoes alone. Custom-molded shoes have higher approved amounts, often several hundred dollars, so your coinsurance would be proportionally higher. Inserts add to the total, but each pair is generally approved at a lower amount than the shoes themselves. If you have a Medigap (supplemental) policy, it may cover part or all of your 20% coinsurance.
Who Qualifies for Diabetic Shoes
Not everyone with diabetes automatically qualifies. Your doctor (an M.D. or D.O.) must certify that you have diabetes, that you’re being treated under a comprehensive diabetes care plan, and that you have at least one of the following foot conditions:
- Previous amputation of the other foot, or part of either foot
- History of foot ulceration on either foot
- History of pre-ulcerative calluses on either foot
- Peripheral neuropathy with evidence of callus formation
- Foot deformity on either foot
- Poor circulation in either foot
The qualifying condition must be documented in your medical record. A diagnosis of diabetes alone is not enough. The certifying physician needs to confirm that the foot condition creates a medical need for therapeutic footwear specifically because of your diabetes.
How the Certification Process Works
The process involves two professionals. First, your treating physician (the M.D. or D.O. managing your diabetes care) fills out a Statement of Certifying Physician. This form confirms your diabetes diagnosis, identifies which qualifying foot condition you have, and states that therapeutic shoes are medically necessary. Your doctor must be actively managing your diabetes under a comprehensive treatment plan for the certification to be valid.
Second, a separate provider actually prescribes and fits the shoes. This is typically a podiatrist or other qualified professional. The prescribing provider writes the specific footwear order, including whether you need custom-molded or extra-depth shoes, and handles the fitting. The certifying physician and the prescribing provider can be the same person only if that doctor is a podiatrist or other qualified shoe fitter, which is uncommon in practice.
Where to Get the Shoes
You must get your diabetic shoes from a supplier enrolled in Medicare’s Durable Medical Equipment program. This includes podiatrists who dispense shoes, orthotists, prosthetists, and pedorthists, as well as some specialized shoe stores that have enrolled as Medicare suppliers. Buying shoes from a non-enrolled retailer means Medicare won’t reimburse any of the cost, even if you have a valid prescription.
Before your appointment, confirm that the supplier accepts Medicare assignment. Suppliers who accept assignment agree to charge only the Medicare-approved amount, which limits your out-of-pocket cost to the 20% coinsurance. Suppliers who don’t accept assignment can charge up to 15% more than the approved amount, and you’d be responsible for the difference plus your coinsurance.
Getting the Most From This Benefit
Because the benefit resets every January 1, timing matters. If you get shoes in December, you can get another pair the following month. On the other hand, if you get shoes in January and need replacements by November, you’ll have to wait until the next calendar year. Plan your timing based on how quickly your footwear wears out.
Keep in mind that the insert benefit is where much of the practical value lies. Inserts wear down faster than shoes, and Medicare covers two or three replacement pairs per year depending on your shoe type. If your inserts lose their shape or cushioning before the year is up, check whether you’ve used your full annual allowance before buying replacements out of pocket.
If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your plan must cover at least what Original Medicare covers, but the process, approved suppliers, and cost-sharing may differ. Check with your plan directly for specifics on prior authorization requirements and network restrictions.