Diabetic Footwear Guide: Medicare Coverage & Best Shoes Michigan

Quick answer: Medicare’s Therapeutic Shoe Benefit covers one pair of depth or custom-moulded shoes plus three pairs of inserts per calendar year for people with diabetes who also have a qualifying complication such as neuropathy, deformity, prior ulcer or amputation. The doctor managing your diabetes certifies it; a podiatrist prescribes and fits. Book online, or call (810) 206-1402.

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.

Medicare Part B covers therapeutic diabetic footwear for diabetic patients who meet specific qualifying criteria — yet the majority of eligible Medicare beneficiaries with diabetes do not receive this benefit each year. At Balance Foot & Ankle in Southeast Michigan, Dr. Tom Biernacki is a qualified supplier of the Medicare Therapeutic Shoe Bill benefit and provides a streamlined, in-office process for eligible patients: assessment, prescription, fitting, and delivery of depth-inlay shoes and custom-molded inserts at minimal out-of-pocket cost. Our main reference on diabetic shoes covers the construction standards a shoe has to meet, how to get the fit right, and how to break a new pair in safely.

Medicare Coverage for Diabetic Shoes

The Medicare Therapeutic Shoe Bill (HCPCS codes A5500-A5513) covers: one pair of extra-depth shoes OR one pair of custom-molded shoes per calendar year; PLUS three pairs of inserts per calendar year (or two pairs of custom-molded inserts for custom shoes). Medicare Part B pays 80% of the approved amount after the annual Part B deductible is met; supplemental insurance typically covers the remaining 20%. Out-of-pocket cost for most patients with supplemental coverage: $0–$30. Qualifying criteria: documented diabetes diagnosis; treating physician (endocrinologist, primary care) must certify that the patient has diabetes AND has at least one of the following: peripheral neuropathy with evidence of callus formation; history of pre-ulcerative calluses; history of previous ulceration; foot deformity; previous amputation; or poor circulation. The certifying physician submits a Certificate of Medical Necessity (CMN) which is then used by Balance Foot & Ankle to dispense the appropriate footwear.

What to Look for in Diabetic Footwear

Beyond the Medicare benefit, all diabetic patients should understand the non-negotiable footwear requirements for diabetes foot protection. Extra depth: at least 3/8″ additional interior depth compared to standard shoes — accommodates swollen feet, deformities (bunion, hammertoe), and custom inserts without creating pressure points. Wide toe box: toes should not be compressed laterally or dorsally — a toebox that contacts the toes creates pressure over hammertoes, bunions, and prominent metatarsal heads, which becomes a wound in a patient with neuropathy. Seamless interior: any interior seam or stitch that contacts the foot is a potential pressure point — diabetic patients cannot feel this pressure until it has already caused skin breakdown. Stiff heel counter: stabilizes the calcaneus and prevents lateral drift of the foot within the shoe that creates shear at the heel. Removable insole: accommodates custom inserts or orthotics for total contact fit. Rocker sole (for specific indications): a rocker-bottom sole designed to offload the metatarsal heads and forefoot — indicated for patients with forefoot wounds, Charcot deformity, or significant metatarsalgia. Avoid: sandals, flip-flops, shoes without back straps, barefoot walking, and slip-on shoes without heel support — all create conditions for skin breakdown in the diabetic foot.

Frequently Asked Questions

Diabetic with Medicare? You may qualify for no-cost therapeutic shoes. Contact Balance Foot & Ankle in Southeast Michigan — call (810) 206-1402 to find out if you qualify.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your diabetic foot conditions, our podiatry team at Balance Foot & Ankle can help with same-week evaluations and advanced in-office care.

What is Diabetic foot?

Diabetic foot is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.

Symptoms and warning signs

Common signs of diabetic foot include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.

Conservative treatment options

Most cases of diabetic foot respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.

When is surgery considered?

Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.

Recovery timeline and prevention

Recovery from diabetic foot varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.

More questions patients ask

How often should diabetics check their feet?

Diabetic patients should perform daily self-examinations of both feet, checking for cuts, blisters, redness, swelling, calluses, and temperature changes. Professional diabetic foot exams should occur at least annually, or every 3-6 months for patients with neuropathy, peripheral artery disease, or history of foot ulcers. Dr. Biernacki provides comprehensive diabetic foot care programs.

Why do diabetics have foot problems?

Diabetes causes peripheral neuropathy (nerve damage reducing sensation), peripheral artery disease (reduced blood flow), and impaired immune function. This combination means injuries go unnoticed, heal slowly, and are prone to infection. Approximately 15% of diabetics will develop a foot ulcer, and diabetic foot complications are the leading cause of non-traumatic amputation. Prevention through regular podiatric care is essential.

What are the signs of diabetic neuropathy in feet?

Early signs include tingling, burning, or numbness starting in the toes and progressing upward. Other symptoms include sensitivity to touch, muscle weakness, balance problems, and loss of reflexes. If you experience any of these symptoms, schedule an evaluation with Dr. Biernacki at 810-206-1402 for nerve conduction testing and a comprehensive neuropathy management plan.

Still have a question about coverage or cost? Book online and we will check your benefits before your visit: Book in Howell · Book in Bloomfield Township. Prefer to talk it through first? Call (810) 206-1402.