A podiatrist is a doctor who provides foot care to treat a variety of conditions, including ankle injuries, foot deformities, nail disorders, and diabetic foot care. If you have Original Medicare and require podiatric treatment, you may want to review your coverage options, since Original Medicare does cover podiatry services, but only under certain conditions.
Medicare Part B, which acts as medical insurance, covers medically necessary foot care services, including the treatment of foot injuries and diseases. However, routine foot care is typically not covered by Original Medicare unless it’s part of a broader treatment plan for a specific medical condition. In this article, we’ll discuss which podiatry services are and aren’t covered by Medicare Part B and review the cost of podiatry care under Original Medicare.
What podiatry services are covered by Medicare Part B?
Medicare Part B only covers medically necessary treatment for the foot, ankle and lower leg. This means that Medicare Part B usually won’t cover routine foot care procedures unless you have a medical condition, like diabetic neuropathy, and routine treatment is required for preventing further harm. Medicare Part B may cover podiatry treatment related to:
Hammer toe
Bunion deformities
Heel spurs
Diabetes-related nerve damage
Severe diabetic foot disease (like therapeutic shoes and inserts)
Medicare Part B will also cover one foot exam per year if you have diabetes-related lower leg nerve damage that increases the risk of limb loss. However, this exam will only be covered if you haven’t seen a foot care provider for another reason in between visits. In order for Medicare Part B to cover your podiatrist visit, you may need to first receive a diagnosis for a particular condition or other qualifying reason for your podiatric care.
What podiatry services are not covered by Medicare Part B?
If you have Original Medicare, you may still need to pay out of pocket for certain services and podiatric visits. For example, routine foot care is not covered by Medicare Part B because it’s not deemed medically necessary. This includes services like:
Trimming/clipping nails
Removing calluses or corns
Hygienic maintenance like cleaning or soaking of the feet
In these cases, you’ll likely pay 100% of the cost. The only exception is if these services are part of a more comprehensive treatment plan for a specific medical condition, in which case they may be covered by Part B.
Cost of Podiatry Care Under Original Medicare
The cost of podiatry services under Original Medicare will vary depending on factors like the type of treatment you receive, your provider and the facility where you’re receiving care. After you meet your Part B deductible, which is $226 in 2023, you’ll pay 20% of the Medicare-approved amount for medically necessary foot care services.
If you’re receiving treatment in an outpatient hospital setting, you’ll also pay a copayment, the amount of which will vary by situation. These costs may vary if you have Medicare Part C, a Medicare Advantage plan, which will offer the same coverage as Original Medicare, but may include additional routine services or treatments.
SelectQuote Can Answer Your Questions About Medicare Advantage and Podiatry
Navigating Medicare Advantage coverage can be tricky, especially when you’re unsure whether your current plan covers your unique needs. Since Medicare Advantage Plans must offer the same services as Original Medicare, you may also find additional coverage through MA plans, and SelectQuote can help.
We’ll take the time to learn about your unique healthcare needs, then search recognized Medicare Advantage plan carriers to match you with the right fit. Our licensed insurance agents have the experience and knowledge needed to help you navigate the complexities of Medicare.
