Recognizing that properly fit shoes and orthoses were critical for people with diabetes, in May 1993 Congress amended the Medicare statutes to provide partial reimbursement for depth shoes, custom-molded shoes, and shoe inserts or modifications to qualifying Medicare Part B patients with diabetes.
To qualify, the medical doctor who manages the patient’s systemic diabetic condition, (i.e. prescribes insulin) must certify in a Statement of Certifying Physician that the patient has diabetes, that the patient is being treated under a comprehensive plan of care for diabetes, that the patient has one or more of the conditions that Medicare describes as placing the patient at risk for amputation and that the patient therefore needs therapeutic footwear.
With two documents, the above-mentioned Statement of Certifying Physician and a Footwear Prescription, Medicare will partially reimburse the beneficiary for the footwear, footwear modifications and foot orthoses needed to protect their feet. More information regarding the program can be obtained from Medicare at 800-270-2313 or www.cms.gov.

Many private insurances have followed Medicare’s lead in providing special footwear benefits for their policy holders with diabetes. Contact your health insurance company for more information.


Caring For Your Feet

Always follow your doctor’s instructions for foot care.
• Revisit your Certified Pedorthist one week after getting new footwear and no less than once every three months for a check-up.
• Keep your blood sugar in control.
• Inspect your feet for trouble signs everyday, report any changes to your physician. If it is difficult for you to see your feet, try using a mirror.
• Wash your feet daily using lukewarm water and mild soap. Test the water temperature first with your elbow.
• Dry your feet carefully with a soft towel, especially between the toes.
• Dust your feet with talcum powder or cornstarch.
• Use lanolin lotion or petroleum jelly if the skin is dry. Be careful not to get it between the toes.
• Check your shoes, socks, and orthoses daily for stones or foreign objects that can cause sores.
• Wear thick, soft socks—preferably socks designed for the diabetic foot. Avoid mended socks or those with seams. Change socks daily. Avoid knee-highs or dress socks with tight elastic bands.
• Do not wear shoes without socks.
• Never go barefoot – wear some sort of supportive footwear at all times to avoid cuts or other foot injuries, particularly if you have loss of sensation.
• If your feet are cold at night, wear loose, cotton socks to bed. Do not use hot water bottles or heating pads.
• Shop for shoes in the afternoon, when your feet are the largest.
• Don’t smoke.
• Leave foot surgery to the experts; see your doctor if you develop corns, calluses, or ingrown nails. Do not use sharp instruments or home remedies unless approved by your doctor.
• Let your doctor cut your toenails. If you must cut them yourself, cut toenails straight across. Never cut into the corners or taper. Use an emery board or nail file for sharp edges.