Does Medicare cover podiatry?

A podiatrist is a foot doctor. Original Medicare may cover a podiatry visit when a podiatrist treats an injury, infection, wound or other health problem in your foot, ankle or lower leg. In most cases, Medicare pays for podiatry care under Part B. Part A may help only if you get podiatry care during a covered hospital stay.

Medically necessary care helps diagnose or treat a health problem. Medicare doesn’t cover care you get only for comfort or appearance.

Some podiatry care Medicare may cover includes:

• A visit to check new foot or ankle pain
• Care for a foot ulcer or open sore
• Care for an infection or swelling
• Care for joint pain that makes it hard to walk

To help your visit go smoothly:

• Write down when your pain started and what makes it better or worse
• Bring a list of your medications
• Call the office before you go, if you’re not sure Medicare will treat the visit as medically necessary
• Ask which services they plan to bill
• Check your plan rules if you have a Medicare plan

Medicare usually doesn’t cover routine foot care. This is basic upkeep you get for cleaning or comfort, not to treat a medical problem. In most cases, you pay 100% for routine care. With routine foot care, Medicare may not cover:

• Cutting or removing corns and calluses
• Trimming, cutting or clipping nails
• Cleaning and soaking your feet as upkeep
• Padding or simple shoe inserts that are not part of a covered diabetes shoe benefit

Routine foot care can still matter for your health. If you have diabetes, nerve damage or poor blood flow, tell your doctor. A qualifying condition can make some foot care medically necessary. Ask your doctor to document your condition and why you need the service.

Review Aetna Medicare plan options to see what additional benefits may help cover your health care needs  

Medicare may cover some foot care that it would otherwise consider routine when a health condition raises your risk of foot problems. Diabetes, nerve damage and poor blood flow are common examples. For example, Medicare Part B may cover diabetic foot care if you have nerve damage in your legs and loss of feeling in your feet. In some cases, Part B may cover a foot exam every six months by a podiatrist or other qualified provider.

Your doctor may recommend more visits if you have a higher risk of foot injury. Medicare may also cover therapeutic shoes or inserts for some people with diabetes. To qualify, your doctor and supplier must enroll in Medicare. Before you order, ask your doctor if you meet the rules and ask the supplier if they take Medicare. If they don’t, Medicare may not pay.

If you have diabetes, make foot care part of your routine. Set a reminder for regular checks and visits. Ask your care team what to watch for.

Medicare Advantage (Part C) plans cover the same medically necessary podiatry services as Original Medicare. Some plans may also include routine foot care as an added benefit. Your costs and plan rules can vary by provider network.

Some plans ask for a referral or prior approval before you see a specialist. These steps can affect what you pay and when you can get care. Before you book a visit, check your plan details and ask the office if they’re in your network.

Explore Medicare Advantage plans that may include additional benefits such as routine foot care