BCBS Podiatrist Michigan 2026 | Blue Cross Blue Shield DPM

Last Updated:

March 2026

Coverage varies by plan. Call (810) 206-1402 to verify your BCBS benefits. Schedule →

In This Guide

BCBS-Accepted Podiatrist in Southeast Michigan

Blue Cross Blue Shield of Michigan is the state’s largest insurer, covering millions of Michigan residents across commercial, Medicare Advantage, and BCN plans. Balance Foot & Ankle is an in-network provider for BCBS of Michigan and BCN (Blue Care Network), making comprehensive podiatric care accessible and affordable at both our Howell and Bloomfield Township offices.

What BCBS Covers for Podiatry in Michigan

Blue Cross Blue Shield covers podiatric services that meet medical necessity criteria. Commonly covered services include office visits and diagnostic evaluations, in-office X-rays and diagnostic ultrasound (no separate facility fee), surgical procedures (bunion surgery including Lapiplasty® 3D, hammertoe correction, neuroma excision, ingrown toenail removal, ankle ligament reconstruction, tendon repair), conservative treatments for plantar fasciitis and heel pain, custom orthotics with proper medical necessity documentation, ankle sprain and fracture management, diabetic foot care and annual exams, and wound care and debridement.

BCN (Blue Care Network) HMO Patients

BCN HMO plan members typically need a referral from their primary care physician before seeing a podiatrist. Our office helps navigate this process — we can confirm what documentation your PCP needs and often coordinate directly. Once your referral is in place, all medically necessary podiatric services are covered at your HMO in-network cost-sharing level.

BCBS PPO and Community Blue Patients

BCBS PPO and Community Blue members generally do not need a referral to see a podiatrist. As an in-network provider, you pay your standard specialist copay for office visits plus any applicable deductible and coinsurance for procedures. Seeing us in-network rather than out-of-network typically saves hundreds per visit and thousands for surgical cases.

BCBS Medicare Advantage

We accept BCBS Medicare Advantage plans, including BCN Advantage and Blue Cross Medicare Advantage. These plans cover all original Medicare podiatry benefits and often provide additional coverage. Qualifying diabetic patients receive Medicare-covered therapeutic shoes and custom inserts annually. We verify your specific benefits before your visit so there are no billing surprises.

Getting Custom Orthotics Covered by BCBS

Custom orthotics coverage requires documentation of medical necessity linked to a qualifying diagnosis — plantar fasciitis, posterior tibial tendon dysfunction, diabetic foot conditions, and similar. We handle this documentation routinely. For plans requiring prior authorization, we submit it before ordering. Most patients with the qualifying diagnoses above receive coverage.

Both Michigan Locations Accept BCBS

Both offices are BCBS in-network: Bloomfield Township at 43494 Woodward Ave, Suite 208 (serving Oakland County), and Howell at 4330 E Grand River Ave (serving Livingston County, Ann Arbor area, Genesee County). Bring your BCBS card, photo ID, and medication list to your first visit — our billing team verifies benefits before your appointment.

Frequently Asked Questions — BCBS Podiatry Coverage

Do I need a referral to see a podiatrist with BCBS?

It depends on your plan type. BCBS PPO members generally do not need a referral and can schedule directly at (810) 206-1402. BCN HMO members typically need a referral from their PCP. Check your insurance card — it usually indicates PPO, HMO, or Community Blue. We can also confirm when you call.

Does BCBS cover bunion surgery?

Yes — when medically necessary. BCBS requires documentation that conservative treatment was attempted and failed, and that the bunion causes functional impairment. Prior authorization is required before surgery. We obtain authorization and walk you through expected cost-sharing before scheduling any procedure.

Does BCBS cover laser toenail fungus treatment?

Most BCBS plans classify laser onychomycosis treatment as non-covered (cosmetic). Oral antifungal prescriptions are typically covered under your pharmacy benefit. We discuss coverage realities honestly so you can make an informed treatment decision.

Does BCBS cover shockwave therapy (ESWT) for plantar fasciitis?

Coverage varies by plan and typically requires prior documentation of failed conservative treatment (3+ months of stretching, orthotics, and physical therapy). We submit the clinical documentation needed to support authorization requests when ESWT is indicated — and we’ll be transparent about the likelihood of approval before proceeding.

How do I confirm what my specific BCBS plan covers before my appointment?

Call us at (810) 206-1402 with your BCBS member ID. Our billing team performs a benefits verification before your appointment and communicates your expected copay, deductible status, and whether any planned procedures require prior authorization.

BCBS In-Network Podiatrist — Michigan

Blue Cross Blue Shield and BCN accepted at both locations. Same-day appointments available.

☎ (810) 206-1402

Conditions We Treat

• Plantar Fasciitis
• Toenail Fungus
• Bunions
• Custom Orthotics
• Neuropathy
• Diabetic Foot Care

Our Doctors

• Dr. Tom Biernacki, DPM — Founder
• Dr. Carl Jay, DPM — Surgery & wound care
• Dr. Daria Gutkin, DPM AACFAS

Recommended between visits: PowerStep Pinnacle Insoles | SB SOX Compression Socks | Doctor Hoy’s Pain Relief

BCBS Members — Same-Day Appointments

We verify your insurance benefits before your visit. 935K+ YouTube subscribers trust Dr. Tom.

Howell: 4330 E Grand River Ave, MI 48843 | Bloomfield Hills: 43494 Woodward Ave #208, MI 48302

Schedule →

(810) 206-1402

In-Office Treatment at Balance Foot & Ankle

If home care isn’t resolving your your foot or ankle concern, a visit with a board-certified podiatrist is the fastest path to accurate diagnosis and a personalized plan. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin offer same-day and next-day appointments at both our Howell and Bloomfield Hills offices. We perform on-site diagnostic ultrasound, digital X-ray, conservative care, advanced regenerative treatments, and minimally invasive surgery when indicated.

Call (810) 206-1402 or request an appointment online. Most insurance plans accepted, including Medicare, Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare.

Most Common Mistake We See

The most common mistake we see is: Waiting too long before seeking care. Fix: any foot pain lasting more than 4 weeks, or any sudden severe symptom, deserves a professional evaluation rather than more rest.

Warning Signs That Need Same-Day Care