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.

The primary goal of therapeutic footwear is to prevent complications, which can include ulcerations, calluses, or even amputations for patients with diabetes. The diabetic shoes and inserts work together as a preventative system to help diabetics avoid foot injuries and improve mobility.

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).

assortment of diabetic footwear that we provide

Download Diabetic Footwear Prescription Form.

Why Diabetic Shoes Are 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 rear foot 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.

Orthotic Solutions offers more brands and styles of shoes, sneakers and even winter boots than any other supplier in MA! Check out some of these manufacturer websites!

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Insurance Coverage for Diabetic Shoes

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, unless you have a co-insurance, which should cover this.
  • 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, such as Orthotic Solutions. Beware of telemarketers, mail-order companies, and shoe stores who may or may not be participating suppliers.

Questions & Answers

Will insurance cover my diabetic shoes?

Medicare, Mass Health and most insurances will cover one pair of diabetic shoes and 3 pairs of either pre-fab or custom inserts each year.

You MUST have diabetes and one or more foot conditions, such as thickened and hard to trim toenails, ingrown toenail/s, corn, callus, bunion, deformed or hammered toe. Other issues include peripheral neuropathy with callus formation, any amputation or any history of or current ulcer.

Diabetes and one of these conditions must be in your medical record.

We will work closely with your Podiatrist and/or the MD managing your diabetes (PCP or Endocrinologist) to obtain everything we need to get your shoes covered.

How often can I get diabetic shoes?

Medicare and most insurances start a new year January 1st. So if you were to get shoes, for example, March 17, 2020, you could get a new pair after 1/1/21.

Some insurances, including BC/BS and Mass Health, run date to date. So if your first pair was issued 3/17/20, you would not be able to get another pair until after 3/17/21.

OSI will always check your eligibility before issuing new shoes.

I am interested in getting a knee or a back brace. Will it be covered?

Unfortunately, if all you have is straight Mass Health, orthotics and braces would not be covered.

We do, however, accept all secondary MH plans such as Fallon, Tufts, etc.

Medicare and all other insurances that we accept will cover braces for the back and knee.

If you have had a similar brace billed to your current insurance in the past, there is a waiting period which needs to be met before receiving a new one.

For back braces, it is 5 years.

For knee braces, it is between 2-3 years, depending on the brace.

Documentation must be in your medical record within the previous 12 months describing why you would benefit from either a back or knee brace.

If you are in pain, we want to help you! But you may need to make an appointment with your PCP or Ortho to get your pain…and the reason for it, documented before we can help you with a brace.

Do you offer “trials”?

The Last thing we want is to provide a product and then, for whatever reason, not have it work out.

If either you or your fitter is uncertain a product will do what we want it to, we will allow a trial. Most people will know within a week if it will work or not. If successful, we will then submit it to billing. If not, your fitter will pick the item up in his/her travels.

What area do you cover?

Our office is located in Plymouth, MA; however, our seven fitters work from their homes. OSI covers the North and South Shores, Boston, Cape Cod, west to Attleboro and southeast to Swansea.

If you are not sure if you are in our coverage area, please send us a message.

Do you offer in-services on your products?

Absolutely! The fitter covering your area would be more than happy to schedule an in-service with you and your staff!

Do you offer shoe clinics?

Absolutely! We do shoe clinics all of the time…especially for COA’s, Assisted Living Facilities and Senior Housing. We can schedule clinics monthly, quarterly, etc.

What is the warranty for shoes?

We back up what we give our clients to the fullest. If a shoe is ill-fitting, we will work with you to make it right.

If a shoe rips or there is any defect, we will work with the manufacturer to get you a replacement. Some companies offer a 60 day warranty and others 6 months; however, we will do whatever we can to correct any defect.

Can I return my shoes?

It depends.

You should Never wear your shoes outdoors if there is any chance you think you will need to return them. If a shoe looks worn, it cannot be returned.

We also can not return shoes without the box, so Please! Hold onto the shoe box until you are 100% certain they will not have to be returned.

If a shoe is creating problems to your foot, we will work with you to make it right.

I want to get my next pair of shoes. What do I do?

Please call one of our patient coordinators at (774) 205-2278. They will verify all of your information is the same and send out for the necessary paperwork. Once that comes back, your fitter will reach out to you for an appointment.

Do I have to pay a deductible?

Some insurances have a deductible that must be paid before all other services are covered.

If you have a secondary insurance plan, sometimes that will pay it, but not always. It is best to find out if you have a deductible and if you are responsible for paying it prior to receiving services from OSI.

Will I have a co-payment?

Most people have a secondary insurance plan, such as Mass Health, that will cover any co-payment.

If you have a managed care plan, such as, but not limited to, BC/BS or Tufts, you may have to pay a co-payment for DME (Durable Medical Equipment). It is best to check with your insurance plan prior to receiving services from OSI.

Have Questions?

We invite you to experience the difference Orthotic Solutions, Inc. can make in your life.