Does Medicare Cover Podiatry?

Our feet are the unsung heroes of everyday activities, such as walking the dog or hiking with friends. Painful or injured feet can limit your ability to walk, run or even stand, affecting your independence and hampering daily life. As we get older, we need to take steps to take better care of our feet.

“Many pre-existing conditions — such as flat feet, bunions and hammertoe deformities — can worsen with age. Usually, these deformities require surgical correction if symptomatic, so when being evaluated for these deformities, it’s better to address them sooner rather than later,” says Dr. Jacqueline Prevete, a podiatrist at New York-Presbyterian Hospital in New York.

Incorporating regular foot care into your routine can help ensure your feet remain healthy, functional and free from pain, contributing to your overall well-being and quality of life.

[READ: Why Foot Care Is Critical for Seniors.]

Importance of Foot Care

Foot care involves anything from the basic hygiene of clipping toenails to the more complicated care of diabetic nerve damage. It is important to be mindful of your feet and ankles, especially as you age or develop certain health conditions.

Some reasons include:

Early detection of problems. Routine foot care allows for early detection of problems like fungal infections, bunions or plantar fasciitis, making treatment more effective and less invasive.

Enhancing balance and posture. Healthy feet contribute to better balance and posture, reducing the risk of falls and related injuries, particularly in older adults.

Overall health. Foot health is closely linked to overall health. Issues in the feet can indicate systemic health problems, such as diabetes, arthritis, cancer or cardiovascular disease.

Preventing long-term issues. Consistent foot care can help prevent long-term issues, such as arthritis or chronic foot pain, improving your overall quality of life.

“Proper foot care is vital to older Americans’ overall well-being,” says Dr. Jeffrey Lehrman, a podiatrist and adviser to the health policy and practice department of the American Podiatric Medical Association. “Healthy feet and ankles help to ensure senior citizens can stay active and enjoy a richer quality of life. Given the prevalence of conditions, such as diabetes and falls risk factors among older Americans, it is important that seniors have access to care by a podiatrist.”

[READ: Questions to Ask Your Doctor About Diabetes]

When to See a Doctor

A podiatrist is a specialist who treats the foot, ankle and related structures of the leg. Podiatrists treat various conditions, including:

Chronic conditions. Arthritis, diabetes-related foot problems and plantar fasciitis. People with diabetes should see a podiatrist annually.

Deformities. Bunions, hammertoes and flat feet.

Foot and ankle injuries. Fractures, sprains and strains.

Skin and nail disorders. Fungal infections, warts, corns, calluses and ingrown toenails.

Surgical interventions. Corrective surgeries for bone and soft tissue issues.

[SEE: What Makes a Good Doctor: Qualities to Look For]

What Medicare Covers

Podiatry services considered medically necessary are covered under Medicare Part B.

The most common medically necessary treatments provided by podiatrists that Medicare Part B covers include:

— Foot fracture care

— Grafting procedures for limb-threatening ulcers

— Ingrown toenail surgery

— Reconstructive surgery, such as bunion and hammertoe correction

— Toenail and callus care

— Wound care

However, Medicare does not typically cover routine foot care. This includes:

— Cutting or removing calluses and corns

— Hygienic maintenance, such as cleaning and soaking the feet

— Trimming, cutting or clipping nails

Exceptions are made if the patient has certain chronic conditions, such as diabetes, that require these services to prevent complications or worsening of symptoms.

Medicare Advantage plans must cover all services that Medicare Part B provides. On top of that, they sometimes offer additional benefits and that may include broader coverage for podiatry services. It is beneficial to check the specific details of your plan including whether you will need a referral to see this specialist.

What Will Podiatry Care Cost With Medicare?

To receive care under your Medicare benefits, a few requirements need to be met. These include:

Doctor’s referral. Under Medicare Part B, you generally do not need a referral to see a specialist. On the other hand, some Medicare Advantage plans do require a referral from your primary care doctor. Check with your specific plan to see what your requirements are.

Medical necessity. Your podiatrist must document that any treatment is medically necessary for a diagnosed foot condition.

Medicare approved provider. In order to take advantage of your Medicare benefits, you need to make sure your podiatrist is either in-network for your Advantage plan or accepts assignment, which means the doctor takes Medicare Part B.

Your costs will depend on your plan and whether you’ve hit your deductible. After meeting your Part B deductible, beneficiaries typically pay 20% of the Medicare approved service amount. If you have a Medigap plan on top of Part B, your costs may go down or be completely covered. For Medicare Advantage plans, costs and coverage may vary, so check with your plan before seeing your doctor.

Bottom Line

Feet need more attention as we get older. Certain conditions, such as hammertoe or bunions, should be evaluated by a podiatrist sooner rather than later to prevent surgical intervention.

While Medicare Part B covers podiatry services that are deemed medically necessary, such as reconstructive surgery for bunions or hammertoe and arthritic or diabetic foot care, it does not cover routine foot care unless it helps prevent complications or worsening of symptoms.

More from U.S. News

Common Foot Problems in Older Adults: Causes and Treatment

Types of Doctors and Medical Specialists: Which One Should I See?

Questions to Ask Your Doctor About Diabetes

Does Medicare Cover Podiatry? originally appeared on

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