Medicare is a godsend for millions of Americans. It provides monetary assistance and medical insurance coverage for the most vulnerable in our society. They are those over the age of 65 and those with debilitating medical conditions, such as ALS. However, that doesn’t make Medicare infallible. So, does Medicare cover podiatry? Or does it not?
In fact, there are a great many things that Medicare does not cover. Due to it being split into 4 different parts each cover different things; with some of the parts being optional, it can be somewhat confusing to work through.
One thing that people want to know whether it covers or not is podiatric care or not.
After all, people want to be able to move around even if it is slowly. Otherwise they are resigned to one spot for the rest of their lives.
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What is Podiatry?
Podiatry is a medical field of study and practice that is concerned with the lower extremities of the body. Including: the ankle, the foot, and lower limb anatomy.
It is focused on the study, hypothesis, diagnostic analysis, and medical or surgical treatment within these areas.
While podiatry is a specialty, and it requires many years to become a trained Podiatrist, Podiatry physicians rotate through all other major areas of medicine that are not specialized during the three-year residency, before their podiatry training.
This gives them a broad range of skills and a lot of experience. Which they can put to use once they become a trained podiatrist.
This is because many of the conditions that affect the lower extremities of the body can start in other places. Or have other causes beyond those you see on the leg—a nervous system disorder, for example.
Though, a podiatrist’s main focus is to provide the following: a number of foot and leg related services, including preventive foot care, diagnosis and treatment of foot disorders and diseases, management of diabetic foot care, and surgical care of the foot and leg.
Podiatry vs Routine Foot Care
Before we look at podiatry and Medicare, it is important to note the difference between routine foot care and podiatry.
Most people think they fall under the same umbrella. While they are related to the same areas of the body, they are quite different in practice.
Routine foot care’s relation to podiatry can be seen more like the relation between fitness and diet.
Routine foot care—fitness and diet—is about making sure your feet are doing okay. Occasionally adjusting things to make sure that nothing serious will crop up later down the line.
For example, routine foot care will be cutting corns or shaving calluses, clipping your nails and checking for ingrown ones, or even treating flat feet.
These are all things that help your foot by adjusting aspects of it to prevent further problems.
However, podiatry is a specialized type of care that is about diagnosing, treating, or managing an underlying health issue.
The health issues managed by podiatry are normally quite intricate and serious. Affecting the person’s ability to live a comfortable life or the functionality of that person’s feet—such as diabetic foot care.
As such, routine foot care procedures are not covered by Medicare. Because they are not currently affecting your life; or at least they are seen as easy for you to deal with.
Does Medicare Cover Podiatry Care?
Yes, Medicare does cover podiatric care, but there are exceptions, and it does depend on the situation. So, let’s get down to brass tax and look at how and when Medicare will cover you for podiatry care.
Part A of the Medicare plan is about inpatient procedures and hospital insurance.
It will help to cover the cost of any podiatry care that you receive. But only if and when you are formally admitted to a hospital that has been Medicare approved.
Part B of the Medicare plan is about outpatient procedures, medical insurance, and doctor’s clinic settings. It will help cover the cost of any podiatry care you receive in an outpatient or doctor’s office setting.
However, any podiatry service that is covered in Part B will need to meet some criteria. It needs be ordered and signed off by your personal physician; be deemed medically advisable, and for Part B to be included in your plan. Since Part B is an optional part of Medicare.
Part C of the Medicare plan is Medicare Advantage, and it runs on different rules, depending on the policyholder’s situation.
As such, you will need to check your personal coverage to see whether you would get Podiatry care.
Part D is only related to self-administered prescription drugs. You should be covered if you are prescribed drugs as a part of your Podiatry treatment and have this plan.
Also, you must have been attended to or seen a medical doctor or qualified osteopath at the minimum of six months prior to your podiatric treatment.
With documentation from the medical professional who saw you to prove the visit, before submitting your Medicare claim.
This may seem like a lot, but most Podiatry treatment is covered with Medicare, just make sure you check that yours is before you start trying to claim or seek treatment beyond your means.
Does Medicare Cover Include Supportive Foot Devices?
Yes, Medicare does cover supportive foot devices, as long as Medicare approves your claim, and you go to a Medicare approved provider of these devices.
This includes items such as arch supports, cushioned insoles, a custom molded pair of shoes, and toe spacers.
With Medicare, you should only pay up to 20% of the cost of these devices (Medicare approved, of course) and the Part B deductible will apply in this situation.
Medicare covers most of the cost of Podiatric treatment, with some exceptions.
This is because without Podiatric treatments, a person’s quality of life can go way down and so most procedures and services relating to medical assistance are covered, as long as you have the full Medicare plan.
In most cases, yes; they regularly assist patients with toenail care. While cutting toenails may seem like a simple matter of grooming, there are actually many patients who have problems with their toenails or feet that prevent them from cutting them without professional help.
Some of the medical conditions podiatrists treat include heel pain (plantar fasciitis), foot complications from diabetes, ankle and foot arthritis, nerve problems, tendonitis, hammertoes, flat feet, nail disorders, bunions, warts, fungus, fractures, and sprains.
Everyone with diabetes should have an annual foot check.
Your foot check is part of your annual review, which means you should have it as part of your diabetes care and it’s free on the NHS. This is because you’re more likely to have serious foot problems and these can lead to amputations.