Medicare covers therapeutic shoes only for people with diabetes. If you don’t have a diabetes diagnosis, Medicare will not pay for orthopedic shoes, no matter how severe your foot problems are. This is one of the most common surprises for people searching for footwear coverage, so understanding exactly what qualifies (and what doesn’t) can save you time and frustration.
Who Qualifies for Coverage
Medicare Part B covers therapeutic shoes and inserts under a specific benefit tied to diabetes. To qualify, you need a diabetes diagnosis plus at least one of the following foot-related complications:
- Previous amputation of the other foot, or part of either foot
- History of foot ulcers on either foot
- Pre-ulcerative calluses on either foot
- Nerve damage (peripheral neuropathy) with callus formation on either foot
- Foot deformity on either foot
- Poor circulation in either foot
Having diabetes alone is not enough. You must have at least one of those qualifying complications documented in your medical records. The rationale behind this benefit is prevention: therapeutic footwear helps people with diabetes avoid ulcers, infections, and amputations that are far more costly to treat.
What Medicare Won’t Cover
If you need orthopedic shoes for bunions, plantar fasciitis, hammertoes, heel spurs, arthritis, or any other foot condition without a diabetes diagnosis, Medicare will not pay. There is no general orthopedic footwear benefit under Original Medicare. This applies even if your doctor considers the shoes medically necessary for a non-diabetic condition.
Some Medicare Advantage (Part C) plans offer broader benefits than Original Medicare, so it’s worth checking your specific plan if you have one. But under standard Part B, the diabetes requirement is firm.
Two Types of Shoes Covered
Medicare recognizes two categories of therapeutic footwear for qualifying beneficiaries: depth shoes and custom-molded shoes.
Depth shoes look like regular shoes but have extra room inside. When you remove the built-in filler, they provide at least 3/16 of an inch of additional depth to accommodate custom inserts. They come in standard sizes and at least three widths, and they must have a proper closure (laces, straps, or velcro). For most people who qualify, depth shoes with custom inserts are the starting point.
Custom-molded shoes are built from a plaster or foam model of your individual foot. They’re reserved for people whose foot deformities are severe enough that depth shoes can’t provide a proper fit. These shoes also include removable inserts that can be swapped or adjusted as your condition changes. Both types must be made from leather or a material of equivalent quality.
How Many Pairs You Can Get
Medicare covers one pair of therapeutic shoes per calendar year. Along with the shoes, the benefit includes up to three pairs of custom inserts per year. Alternatively, you can get the shoes with modifications (such as rocker soles or wedges) instead of the inserts if your provider determines that’s a better fit for your needs. The annual limit resets each January, so you can get a new pair each calendar year as long as you continue to meet all the qualifying criteria.
The Certification Process
Getting coverage requires two different doctors to be involved, which catches some people off guard.
First, the physician who manages your diabetes (often your primary care doctor or endocrinologist) must certify that you have diabetes, that you have one of the qualifying foot complications, and that you’re being treated under a comprehensive diabetes care plan. This certification needs to happen before the shoes are prescribed.
Second, a podiatrist or other qualified doctor must write the actual prescription for the shoes or inserts. The prescribing doctor and the certifying doctor can be the same person, but both roles need to be fulfilled and documented.
You then get fitted and receive your shoes from an authorized provider: a podiatrist, orthotist, prosthetist, pedorthist, or another qualified supplier enrolled in Medicare’s durable medical equipment program. Buying shoes on your own from a regular store and seeking reimbursement will not work. The supplier must be enrolled with Medicare as a DMEPOS (durable medical equipment) supplier and hold proper accreditation.
What You’ll Pay Out of Pocket
Therapeutic shoes fall under Medicare Part B, so the standard cost-sharing rules apply. You’ll pay 20% of the Medicare-approved amount after meeting the annual Part B deductible, which is $240 in 2024. Medicare picks up the remaining 80%. If you have a Medigap (supplemental) policy, it may cover some or all of your 20% coinsurance, depending on the plan.
Keep in mind that Medicare sets approved payment amounts for therapeutic footwear, and these amounts may be lower than what some suppliers charge. If your supplier accepts Medicare assignment, they agree to the Medicare-approved amount as full payment. If they don’t accept assignment, you could owe more. Always confirm with the supplier before your fitting.
Options If You Don’t Have Diabetes
For people without diabetes who need supportive or corrective footwear, the options under Medicare are limited. Standard orthopedic shoes are considered a personal comfort item and explicitly excluded from coverage. However, there are a few related items that may be covered in certain situations.
Custom orthotics (shoe inserts) prescribed as part of a leg brace that’s medically necessary may be covered under Medicare’s orthotics benefit, but the insert must be attached to or integral to the brace. Standalone shoe inserts for conditions like flat feet or plantar fasciitis are generally not covered.
If you have a Medicare Advantage plan, check your plan’s summary of benefits. Some plans include allowances for over-the-counter health items or supplemental benefits that could partially offset footwear costs. Outside of Medicare entirely, some state Medicaid programs cover orthopedic shoes for qualifying conditions regardless of diabetes status, so that may be worth exploring depending on your income and state of residence.