★ 4.9 Stars · 1,123+ Reviews · Board-Certified Michigan Podiatrists
Custom Orthotics Michigan
Physician-Grade Insoles That Actually Work
Custom orthotics from a board-certified podiatrist are prescription medical devices, not store-bought insoles. Built from 3D scans of your foot to correct your specific biomechanics — for plantar fasciitis, flat feet, diabetic pressure redistribution, and more.
2026 Update
Medically reviewed
by Dr. Tom Biernacki DPM, Board-Certified Podiatric Surgeon · Last updated:
March 2026
Custom orthotics are one of the most over-prescribed and under-explained treatments in podiatry. As someone who both prescribes them and directs patients to OTC alternatives, here’s my honest take on when they’re worth $400–700.
Custom vs OTC: What’s the Actual Difference?
OTC orthotics (like PowerStep Pinnacle) are mass-produced in standard arch profiles. Custom orthotics are cast from your foot and fabricated to your specific biomechanical needs. For most patients with mild-moderate flat feet or plantar fasciitis, a good OTC orthotic at $35 performs comparably to a $500 custom device. The difference matters most in complex biomechanical problems, post-surgical cases, and progressive deformities.
When Custom Orthotics Are Worth It
- OTC orthotics have failed after 8+ weeks of consistent use
- Significant limb length discrepancy
- Post-surgical offloading needs
- Complex biomechanical deformities (severe pronation, Charcot foot)
- Pediatric foot conditions
- High-performance athletes with specific gait demands
Cost and Insurance
Custom orthotics typically run $400–700 out of pocket. Many insurance plans cover them when prescribed by a podiatrist with documented medical necessity. Medicare covers therapeutic shoes/inserts for diabetics; custom functional orthotics require supplemental coverage.
Related
- Are Orthotics Worth It? — Full cost-benefit analysis
- Podiatrist-Recommended OTC Orthotics
Frequently Asked Questions
How long do custom orthotics last?
Typically 2–5 years with regular use, depending on activity level and materials. They should be evaluated at each annual visit.
Can I get custom orthotics without seeing a podiatrist?
You can get ‘semi-custom’ orthotics online (from scan apps), but true custom orthotics require a plaster cast, foam box impression, or 3D scan from a healthcare provider.
Does insurance cover custom orthotics?
It depends on your plan. Many commercial insurers cover functional foot orthotics when prescribed for a diagnosed condition. Always verify your coverage before ordering.
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Dr. Tom Biernacki DPM sees patients in Howell and Bloomfield Hills, MI. Most insurance plans accepted.
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Serving Michigan Patients Near You
Custom orthotics are available at all Balance Foot & Ankle locations in Michigan:
- Custom Orthotics in Brighton, MI
- Custom Orthotics in Fowlerville, MI
- Custom Orthotics in Hartland, MI
- Custom Orthotics in Howell, MI
- Custom Orthotics in Milford, MI
- Custom Orthotics in Pinckney, MI
- Custom Orthotics in South Lyon, MI
Showing 7 Michigan locations. Book an appointment →
Frequently Asked Questions
Answered by Dr. Tom Biernacki DPM, Board-Certified Podiatrist
Are custom orthotics worth the cost?
For most patients with structural foot problems (flat feet, high arches, leg length discrepancy), custom orthotics deliver results that OTC insoles cannot. They’re especially cost-effective for recurrent plantar fasciitis, posterior tibial tendon dysfunction, and diabetic foot care, where they prevent expensive complications.
How are custom orthotics made?
Dr. Tom uses 3D foot scanning to create a precise digital mold of your foot. This data is used to fabricate orthotics that match your exact foot shape, correct your specific gait abnormalities, and provide the appropriate level of support. The process takes 2-3 weeks from scan to delivery.
How long do custom orthotics last?
Functional (rigid) orthotics last 3-5 years with proper care. Accommodative (soft) orthotics typically last 1-2 years depending on activity level. Dr. Tom recommends annual check-ups to assess wear and ensure they’re still providing optimal correction.
Can I use custom orthotics in all my shoes?
Custom orthotics can be transferred between shoes that have a removable insole. Full-length orthotics work in athletic shoes, work boots, and casual shoes. 3/4-length orthotics can fit into dress shoes and women’s flats. Very thin, low-profile orthotics can be fabricated for high heels.
Do I need a prescription for custom orthotics?
Yes — custom orthotics require a physician prescription and gait analysis. Beware of ‘custom’ orthotics at kiosks or shoe stores that only use a pressure plate; these are not truly custom and won’t provide prescription-level correction. Insurance sometimes covers custom orthotics with a documented medical necessity.
What is the difference between custom orthotics and OTC insoles?
OTC insoles (like PowerStep Pinnacle) provide generic support and cushioning. Custom orthotics are fabricated to your specific foot shape and biomechanical needs. For simple arch support or cushioning, OTC is often sufficient. For correcting overpronation, supination, or structural deformities, custom orthotics are far superior.
Dr. Tom’s Pick: CURREX RunPro Insoles for Runners
CURREX RunPro are biomechanically tuned running insoles with 3 arch profiles (low, medium, high) to match your foot type. Unlike generic insoles, they’re engineered specifically for the high-impact demands of running — reducing pronation stress and metatarsal loading.
View CURREX RunPro on Amazon →
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases.
Dr. Tom’s Product Recommendations:
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Related Conditions
Local Custom Orthotic Fittings
- Custom Orthotics Troy
- Custom Orthotics Royal Oak
- Custom Orthotics Howell
- Custom Orthotics Bloomfield Hills
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Same-week appointments available at both locations.
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Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Most insurance accepted · On-site X-ray · Board-certified podiatrists
Howell · (810) 206-1402 Bloomfield · (248) 335-0322Frequently Asked Questions
How much do custom orthotics cost?
Custom orthotics from a board-certified podiatrist typically cost $300-$600 per pair. Many insurance plans cover custom orthotics with a doctor’s prescription. We verify your benefits before ordering. Medicare covers therapeutic insoles for diabetic patients.
How long do custom orthotics last?
With proper care, physician-grade custom orthotics last 3-5 years for adults and 1-2 years for growing children. Signs you need replacement: the material is worn down, you notice increased pain, or your foot mechanics have changed significantly.
Custom orthotics vs. store-bought insoles — which is better?
Store-bought insoles provide general cushioning and are appropriate for mild discomfort. Custom orthotics are prescription medical devices designed from a 3D scan of your specific foot to correct your biomechanical issues. For conditions like plantar fasciitis, flat feet, or diabetic foot complications, custom orthotics are significantly more effective.
Are custom orthotics covered by insurance?
Many plans cover custom orthotics with a physician prescription and documented medical necessity. Medicare covers orthotics for diabetic patients under certain conditions. We verify your benefits and obtain pre-authorization before ordering, handling all paperwork for you.
Can I use custom orthotics in multiple pairs of shoes?
Yes. We make duplicate orthotics for different shoes, or design orthotics in a transfer-friendly profile that fits most closed-toe shoes. Athletic patients often get one pair with multiple top covers for different shoe types. Ask about our multiple-pair pricing options.
Medical References & Resources
- Custom orthotics prescription guidelines — American Podiatric Medical Association (APMA)
- Orthotic research and clinical evidence — Journal of Foot & Ankle Research
Watch: Are Custom Orthotics Worth It?
Dr. Tom Biernacki, DPM — 950K+ YouTube subscribers · 156M+ video views · Michigan’s most-watched podiatrist.
OTC Insoles to Try First
Before committing to $500+ custom orthotics, try a top OTC for 6–8 weeks. If it resolves your symptoms, you just saved hundreds.
Best Insoles for Flat Feet
Rigid arch-shell insoles that correct overpronation at the source.
Powerstep Pinnacle vs Maxx vs Pulse
Head-to-head: which Powerstep fits which foot type.
Custom Orthotics vs OTC Insoles
A podiatrist's honest cost-benefit analysis.
Watch Dr. Tom on Custom Orthotics
Dr. Tom’s diagnostic criteria for when custom orthotics are worth it — and when OTC insoles work just as well.
OTC Insoles to Try Before Going Custom
Not every patient needs $400+ custom orthotics. Our protocol: try one of these first. If it resolves your pain, you may not need custom. If it helps but not enough, we cast custom with confidence.
PowerStep Pinnacle Insoles
Our #1 starter recommendation — neutral arch support that resolves ~40% of mild-to-moderate PF cases outright.
Check Amazon Price →PowerStep Pinnacle-Alternative Firm Support Insoles
Higher-volume, firmer insole for severe overpronators and flat feet — the step between PowerStep and custom.
Check Amazon Price →Strassburg Sock (Night Splint)
Complement to any orthotic for PF patients — prevents overnight fascia contracture.
Check Amazon Price →Structured Walking Shoe (Podiatrist-Approved)
Orthotics only work inside a supportive shoe. Skip this step and no insole will help.
Check Amazon Price →Affiliate disclosure: Amazon links are affiliate links — we earn a small commission if you buy through them, at no cost to you. We only recommend products we actually prescribe to patients at Balance Foot & Ankle.
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