Does Medicare Cover Care for Ingrown Toenails? 

Ingrown toenail is a type of nail disease that can occur more often in seniors. As nail tissue ages, toenail changes and disorders may arise. Your chances of getting an ingrown toenail might increase if:

• You wear shoes that don’t fit properly
• You cut your nails too short or improperly along the edges
• You have broken nails
• You injure a toe or toenail
• You’re genetically predisposed to this condition
• You have overly curved toenails 

You can help avoid ingrown toenails by trimming your nails straight across and keeping them at the right length – not too long or short – and by wearing the right size and kind of shoes. 

If you get an ingrown toenail, it can cause pain, redness, swelling, tenderness, and infection around the nail. In extreme instances, an ingrown toenail can cause underlying bone tissue to become infected.  An ingrown toenail can be even more serious for people who have diabetes and nerve damage to their feet. They may not notice any pain and without proper blood flow to the toes, gangrene can occur. 

It’s important to have your podiatrist or other health care provider check your feet and toenails regularly if you’re prone to this type of nail disease or if you suspect you have an ingrown toenail.  

Does Medicare cover care for ingrown toenails? 

Original Medicare doesn’t typically cover routine foot care. You pay 100 percent of the cost for foot care services that can include:

• Removal or trimming of corns and calluses
• Nail cutting
• Cleaning, soaking, or other forms of hygienic foot care

However, Original Medicare Part B (medical insurance) may cover treatment for an ingrown toenail if your health care provider certifies that it is medically necessary to treat or prevent a health issue. 

Here’s a look at what Medicare Part B covers regarding ingrown toenail care:

• Visits with a health care provider who accepts Medicare assignment for examination, diagnosis, and a treatment plan. 
• The procedure to trim or remove the toenail (only if it’s certified as medically necessary) in a medical office or facility that accepts Medicare assignment. 
• Durable medical equipment (DME) such as special shoes or orthotics that are certified as medically necessary to alleviate pain or discomfort from the ingrown toenail. The DME must be purchased or rented from a supplier that accepts Medicare assignment. 
• If you’ve been diagnosed with diabetes, you may have Medicare coverage for routine foot care including toenail clipping, but you should discuss your coverage allowances with your health care provider. 

Original Medicare Part B covers 80 percent of the cost for covered services if you qualify for coverage. You pay 20 percent after covering your annual deductible. 

If your physician prescribes an antibiotic as part of your treatment for an ingrown toenail, you must be enrolled in a Medicare prescription drug (Part D) plan to get coverage. 

Medicare Advantage (MA)plans often provide additional coverage and extra benefits beyond Original Medicare Parts A and B. An MA plan may offer a wide range of benefits, including  coverage for routine foot care. 

How much does ingrown toenail care cost without Medicare insurance? 

How much you pay for your ingrown toenail treatment depends on where you live, who does the treatment, and how much of the nail must be removed. 

Without Medicare coverage, you may pay around $50 for over the counter, in-home treatment. But if you need to visit a health care professional for partial or complete removal, it typically costs between $200 and $1000.