Does Medicare Cover Podiatry? 

Foot care is often overlooked when it comes to overall health maintenance, but healthy feet can play a major role in your mobility. Injuries to your feet can leave you unable to walk, and conditions like diabetes may lead to foot pain and more serious health concerns.  Injuries, inflammation, or irritation on your feet can be uncomfortable, but without proper care, sores may lead to serious infections.

While a primary care physician is usually your first point of contact regarding injuries to the feet or illnesses that affect the feet, a podiatrist is a healthcare specialist who deals exclusively with foot care. Podiatrist services can assist with a variety of foot health concerns, including the side effects of diabetes, bunions, foot injuries, arthritis, nerve conditions and more. A podiatrist may work in concert with other specialists when treating problems with the feet, including orthopedists, wound care specialists and infectious disease doctors.

Statistically, seniors are more likely to face challenges regarding foot care due to foot and ankle injuries being more common among the older population. Additionally, health conditions like diabetes are more likely to affect seniors as the severity of these diseases tends to get worse with time.

Does Medicare cover seeing a podiatrist?

The good news for Medicare recipients is that Medicare does cover podiatry services in most cases. Coverage is typically supplied by Medicare Part B, the outpatient benefit. Medicare Part B coverage includes benefits for medical costs associated with podiatrist visits, clinical treatment, x-rays and diagnostic services as well as outpatient surgical procedures.

Medicare coverage under Part B typically requires you to pay a premium each month in order to maintain your benefits. Additionally, Medicare Part B plans have a deductible that must be met annually in order for benefits to begin applying toward your podiatry services. After you’ve paid your deductible, you may be responsible for coinsurance or copayments, depending on the Medicare plan you have.

Does Medicare cover podiatry while hospitalized?

While Medicare Part B is the most common part of Original Medicare that is used to cover expenses related to podiatry, you may find yourself in need of podiatry services while hospitalized or while admitted to a skilled nursing facility. In these cases, benefits are provided by Medicare Part A, the inpatient benefit.

This may be the case when you have been admitted to a hospital for an unrelated matter and your feet are found to be in need of care, but you may also come upon this situation when recovering after foot surgery. During recovery in a hospital, the facility may supply a podiatrist to treat foot health concerns that may have arisen as the result of surgery complications. If a podiatrist is brought in from outside of the facility’s staff, their billing may fall under Medicare Part B since their services are not directly connected to your inpatient care.

Durable medical equipment and Medicare coverage

Many people who require podiatry services also require the use of mobility aids from time to time. These items could include walkers, wheelchairs, canes, and braces, or more.

Original Medicare typically covers these types of devices under the durable medical equipment (DME) benefits of Medicare Part B. In order for medical equipment to qualify for coverage under Medicare Part B, it must be supplied by a Medicare-approved distributor and must be prescribed by a Medicare-participating physician or specialist.

If you’re enrolled in a Medicare Advantage plan, you will have at least the same coverage as Original Medicare for DME, but many MA plans include additional benefits. Depending on the plan you have chosen, you may be required to get your medical equipment from a supplier within the plan’s network.