DIABETIC
SHOES/MEDICARE THERAPEUTIC SHOE PROGRAM
By: Corinne Gehegan, DPM
It is well known that diabetic patients are prone to foot complications.
These complications may arise if a diabetic individual has peripheral
vascular disease (poor circulation), diabetic neuropathy (loss of
sensation involving the foot and sometimes even as far as the knee),
impaired ability to heal wounds, or structural deformities such as
bunions and hammer toes. Many foot complications can be prevented by
wearing a proper fitting shoe or sneaker. Diabetic foot wear is
available in regular, wide, and extra wide widths. The shoes must be
considered extra depth. The materials may vary and the soles tend to
allow for increased shock absorption. Medicare recognizes the benefit of
preventative diabetic foot care and allows coverage for certified
diabetic shoes and inserts through the Therapeutic Shoe Program.
A depth shoe must meet the following definition to qualify for the
benefit category
a) Has a full length, heel-to-toe filler that when removed provides a
minimum of 3/16 inch of additional depth used to accommodate a
pre-fabricated or custom-molded insert, and
b) Is made from leather or other suitable material of equal quality, and
c) Has some form a shoe closure, and
d) Is available in a full and half sizes with a minimum of three widths
so that the sole is graded to the size and width of the upper portions
of the shoe according to the American standard last sizing schedule or
its equivalent.
The physician managing the beneficiary's diabetic condition must
document and certify the beneficiary's need for therapeutic shoes. To be
covered by Medicare, therapeutic shoes must be prescribed by a
podiatrist or other qualified physician, and furnished or fitted by a
podiatrist or other qualified physician. The podiatrist can perform a
diabetic foot exam to assess the vascular status and neuro-sensory
status of the feet. He or she will also evaluate the skin and nails as
well as the overall structure of the feet. A thorough medical and
surgical history is also obtained in addition to any previous foot
complications. The podiatrist can measure the feet and assist in
selecting the most appropriate style. Prefabricated inserts which are
also known as orthotics are included as a component of the diabetic foot
wear. They are heat molded to accommodate any deformities or areas of
increased pressure. In some cases the patient may be casted for custom
orthotics. Commercial insurances other than Medicare may provide full or
partial coverage for diabetic shoes if certain criteria are met. Of
course, patients who are not diabetic are welcome to purchase the shoes
as they would any pair of shoes at a store. The good news is that the
styles have improved over the years!
Article written by Dr. Corinne Gehegan
To schedule an appointment call (201) 840-7373.
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