INSURANCE

Q:Is foot care covered by Original Medicare or Medicare Advantage Plans?

A:Some foot care is covered. Some is not. Let’s start with coverage provided by Original Medicare. Later, I will touch on coverage provided by Medicare Advantage Plans. Original Medicare In general, Original Medicare Part B will not cover what is classified as “routine” foot care. Routine care includes “trimming, cutting and clipping toenails, the removal of corns and calluses or any other preventive maintenance, including cleaning and soaking the feet.” Medicare Part B will however cover podiatrist services for medically necessary treatment of foot injuries or diseases and treatment that is considered medically necessary for those who have diabetes, cancer, multiple sclerosis, chronic kidney disease, or inflammation of the veins related to blood clots. Medicare also covers toenail care that would be hazardous to your health unless done by a professional. Additional coverage for therapeutic shoes and inserts is available for people who have diabetes and severe diabetic foot disease.

In all cases, your doctor or podiatrist will need to provide evidence that your care is medically necessary for you to qualify for coverage. If your foot care is determined to be medically necessary, you will be responsible for your Part B deductible, copays, and coinsurance. Ask your doctor or health care provider to help you determine your share of the cost. You can also contact Medicare at 1-800-Medicare for more detailed information on your coverage. What about Advantage Plans? Medicare Advantage Plans provide coverage for everything that is covered by Original Medicare. Some Advantage Plans provide additional coverage for routine foot care. Because coverage varies, it is best to contact your insurance agent or your insurance provider to learn whether your foot care is covered. Make sure to ask for the names of podiatrists or other services providers who are in your Plan’s network before you seek treatment. If you have questions concerning your insurance needs, including life, health, Medicare Advantage Plans and Medicare Supplements, contact me at Lmutsko@mutskoinsurance.com or call 440-255-5700.