Medicare and Podiatry Insurance: What’s Covered and How To Get Treated

If you have Medicare or are turning 65 soon, you may have questions about your coverage. Medicare works differently from private insurance, so it’s important to know what’s covered and what you’ll pay.

At The Foot & Ankle Group, we frequently hear questions like:

• Does Medicare cover podiatry services?
• Will it pay for foot surgeries?
• How much will it cost to continue treatment under Medicare?

The good news? We can help you navigate your Medicare benefits so you can make informed decisions about your foot health. We’ll answer the most common questions about Medicare and podiatry insurance coverage.

Is Podiatry and Footcare Covered by Medicare? 

Overall, yes, Medicare Part B covers podiatry services, but only when necessary. This means Medicare will help pay for treatment if your foot condition affects your overall health or mobility. 

What Podiatry Services are Covered by Medicare?

Covered services include:

• Diabetic foot exams and treatment: People with diabetes should note they are at higher risk for foot complications, including ulcers, infections, and nerve damage, and that regular foot exams can help prevent these issues from becoming more serious.
• Foot injuries and infections: Medicare may cover treatment for fractures, sprains, wounds, or infections that require medical attention.
• Medically required toenail care: If you have a condition like diabetes or poor circulation, Medicare may cover toenail trimming to prevent infections.
  

How Much Will It Cost Me?

Knowing how much your podiatry services might cost you is just as important as knowing whether or not Medicare covers podiatry. The cost will depend on the type of Medicare in which you are enrolled and your income, so the exact amount varies from person to person.

Luckily, Medicare provides helpful resources with the basic cost breakdown. You can also find more information about Medicare coverage and foot care here. Interested in routine foot care coverage? There’s a page for that as well.

What Medicare Does NOT Cover

Routine foot care, such as corn and callus removal, nail trimming, and general foot maintenance, is not covered unless you have a qualifying condition, such as diabetes or a circulatory disorder.

How To Get Started With Medicare-Covered Podiatry Treatment

Foot pain won’t go away on its own. Getting the right care now can prevent bigger problems later. To use Medicare for podiatry care, follow these steps to ensure your treatment is covered so you avoid unexpected costs.

1. Check Your Medicare Coverage

Review your Medicare plan to see what podiatry services are covered. Medicare Part B covers medically necessary foot care, while Part A may apply if you need hospital care for a foot condition.

2. Find an In-Network Podiatrist

Schedule an appointment with The Foot and Ankle Group, or search the Medicare.gov provider tool to find Medicare-approved podiatrists. Confirm that your provider accepts Medicare before scheduling an appointment.

3. Get a Referral if Needed

It’s important to know that some Medicare Advantage plans may require a referral from your primary doctor. Original Medicare doesn’t require referrals, but your doctor can help confirm medical necessity.

4. Verify Coverage Before Your Visit

Ask your podiatrist’s office to check if the treatment is covered. Confirm any out-of-pocket costs ahead of time, such as copayments or deductibles.

Questions To Ask Your Provider:

• Is my treatment covered by Medicare or my insurance?
• Will I need a referral or prior authorization?
• Are custom orthotics, nail care, or other podiatry treatments included in my plan?

By following these steps, you can make sure your Medicare benefits cover your podiatry care without unexpected expenses.

What to Expect at Your Appointment

When you visit a podiatrist, your provider will evaluate your foot health and determine whether your condition qualifies for Medicare or insurance-covered treatment. 

If you have diabetes, circulatory issues, or another eligible condition, your doctor may document medical necessity to ensure coverage for specific services.

If your treatment isn’t covered, your podiatrist can discuss out-of-pocket costs, alternative therapies, and potential payment plans to help you get the care you need.

Yes! We Accept Medicare: Get the Foot Care You Need Without Surprise Bills

The Foot & Ankle Group accepts Medicare, so you can work with us to get the help and support you need for foot-related problems. 

We’re happy to answer your foot care questions and talk through how Medicare and podiatry treatment work together. 

Book your appointment today.