The Low Down on Diabetic Shoes
Diabetic therapeutic shoes are, in my opinion, one of the most important parts of my job. Diabetic shoes help save feet, plain and simple. According to the American Diabetes Association, each year 600,000 diabetic patients get foot ulcers, resulting in over 80,000 amputations.
As a podiatric physician I try to embrace preventative care modalities such as regular diabetic foot exams and diabetic shoes to prevent my patients from getting foot ulcers. My patients will tell you that I’m a stickler about these things. I do understand patient concerns over cost, but the vast majority of insurances cover diabetic shoes and insoles. It is widely accepted that preventative medicine is the best medicine, and not only the monetary cost but also the emotional and physical cost of an amputation makes money spent on diabetic shoes and insoles money well spent. So, what makes diabetic shoes and insoles so different from your run-of-the-mill shoe? Which patients need them? And how do you know if insurance will cover them? Read on for the low down on diabetic shoes.
The Definition: Diabetic shoes can also be referred to as extra depth or therapeutic shoes. They are specially designed shoes intended to reduce the risk of skin breakdown in diabetics with co-existing foot problems (such as neuropathy, poor circulation, and foot deformities).
Why They’re So Special:
- Diabetic shoes are extra deep to accommodate diabetic insoles or orthotics.
- They have a built in firm heel counter to provide medial and lateral rearfoot stability.
- The toe box of the shoe is higher so there is plenty of room for toes (even ones that like to stick up like hammertoes).
- There is little to no stitching on the inside of a diabetic shoe. The stitching is on the outside. Sometimes even the smallest prominence can irritate and cause skin breakdown in a diabetic foot.
- The collar around the ankle of the shoe is padded.
- The tongue of a diabetic shoe is thick and padded to help secure the foot back in the shoe.
- The end of the toe box of the shoe is protective to keep toes from being hurt when stubbed.
- Diabetic shoes have a non-skid sole to prevent falls.
- They are specially fitted by measuring the length and width of your foot.
- They are also equipped with a special multi-density diabetic insole that prevents back and forth movement (also known as sheering) of the foot in the shoe. A diabetic shoe isn’t really a diabetic shoe without this insole. Most insurances pay for 3 pairs of these insoles yearly, and they should be changed every 4 months to get the maximum benefit.
Insurance Coverage: It is rare that we come across an insurance plan that does not provide coverage for diabetic shoes and insoles. Medicare has a Diabetic Shoe Benefit, and they have a pretty clear-cut policy regarding this coverage. Even if you don’t have Medicare, many other insurances follow Medicare guidelines, and our office is happy to check out your insurance’s specific requirements. According to Medicare.com to be eligible for diabetic shoes:
You must have diabetes and one or more of the following conditions:
- Nerve damage in your feet with calluses on either foot
- Poor circulation in either foot
- Deformity of either foot
- Calluses on either foot that could lead to ulcers
- A history of past foot ulceration
- Partial or complete foot amputation
- You must have a prescription for the shoes. Our office can help you with this part.
- You must have documentation from the doctor managing your diabetes that you are in fact being treated for diabetes. Our office contacts this physician and provides them with the necessary paperwork for this.
- If you are enrolled in Medicare Part B, after you have paid your yearly deductible, you will pay 20% of the approved Medicare amount for the shoes and inserts. You can think of this as the shoes and insoles being on sale for 80% off.
- If you receive your Medicare through a Medicare Advantage Health Plan then you may owe little to nothing depending on the plan, but you will have to follow your plan’s steps for approval. Our office will be happy to help you with that part too.
- You will save money on your shoes if you order from a Medicare-approved provider. Beware of telemarketers, mail-order companies, and shoe stores who may or may not be participating suppliers.
If you are a diabetic and would like to enquire about diabetic shoes and insoles we at Advanced Foot and Ankle Care would be happy to answer any questions that you may have about them. We have quite a few shoes on display in each of our offices as well as a catalog and a website with even more shoes. Our diabetic shoes come in a variety of styles from athletic to dress, walking to casual. I feel confident that we have a shoe to fit your needs.