Quick answer: Does Medicare Cover Podiatry Michigan affects roughly 1 in 4 adults in our practice. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Book online, or call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
In This Article
- Quick Reference: Michigan Insurer Coverage Table
- Medicare Part B: Your Podiatry Coverage
- Blue Cross Blue Shield (BCBS) Michigan
- Aetna, United Healthcare, Cigna, Humana
- Michigan Medicaid Plans (Meridian, Priority Health, McLaren)
- What Insurance Covers vs. What Requires Documentation
- Do I Need a Referral?
- What You Should Do Right Now
- Your Board-Certified Podiatrists
- Pros & Cons of Conservative Care for foot care
- Dr. Tom’s Recommended Products for foot care
The most important clinical decision with Does Medicare Cover Podiatry Michigan isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Book online or call (810) 206-1402.
Related Conditions
Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle
Last reviewed: May 2026
Does Insurance Cover a Podiatrist in Michigan? Complete Guide (All Insurers)
Medicare, Medicaid, BCBS, Aetna, United Healthcare, Cigna, Humana, HAP, Meridian, Priority Health, McLaren, Workers’ Comp, VA, and most Michigan plans all cover medically necessary podiatric care. We verify your coverage before every visit — no surprise bills.
If you’ve ever wondered whether your insurance covers a podiatrist visit, the short answer is yes — for medically necessary care, nearly every insurance plan covers podiatry. The specifics depend on your plan type. This guide covers every major insurer accepted at Balance Foot & Ankle in Michigan.
Quick Reference: Michigan Insurer Coverage Table
| Insurance Plan | Covers Podiatry? | Referral Required? | Your Cost |
|---|---|---|---|
| Medicare Part B | ✅ Yes — medically necessary | No | 20% after $257 deductible |
| Medicare Advantage | ✅ Yes — often enhanced benefits | Usually no | $0–$50 copay |
| Blue Cross Blue Shield (BCBS) | ✅ Yes — PPO; BCN requires referral | PPO: No / BCN: Yes | $30–$60 specialist copay |
| Aetna | ✅ Yes | PPO: No / HMO: Yes | Depends on plan |
| United Healthcare | ✅ Yes | Choice Plus: No | Depends on plan |
| Cigna | ✅ Yes | Open Access: No | Depends on plan |
| Humana | ✅ Yes | Usually no | Depends on plan |
| HAP (Health Alliance Plan) | ✅ Yes | HMO: Yes (PCP referral) | $40–$60 specialist |
| Meridian Health Plan | ✅ Yes (Medicaid) | May require referral | $0–$3 copay |
| Priority Health | ✅ Yes | HMO: Yes / PPO: No | Depends on plan |
| McLaren Health Plan | ✅ Yes | Usually yes | Depends on plan |
| Oscar Health | ✅ Yes | No | Depends on plan |
| Michigan Medicaid | ✅ Yes — medically necessary | Sometimes | $0–$3 |
| Workers’ Compensation | ✅ Yes — work injuries | No | $0 |
| VA / Tricare | ✅ Yes — veterans/military | VA may require referral | Usually $0 |
| No Insurance (Self-Pay) | N/A — transparent pricing | No | Ask for self-pay rates |
Medicare Part B: Your Podiatry Coverage
Medicare Part B covers all medically necessary podiatric services. This includes evaluation and management for any foot or ankle condition, treatment of bunions, hammertoes, heel pain, fractures, ankle sprains, infections, wounds, and nerve conditions, podiatric surgery, diabetic foot exams (one per year for qualifying patients), routine nail care for patients with qualifying systemic conditions, custom orthotics when prescribed as medically necessary, and therapeutic shoes through the Diabetic Shoe Program (one pair plus three inserts per year).
Your cost: After the $257 Part B deductible, Medicare pays 80% and you pay 20%. With a Medigap supplement, most patients pay $0–$15 per visit. See our Medicare podiatry guide for full details.
Blue Cross Blue Shield (BCBS) Michigan
BCBS offers several plan types in Michigan with different podiatry rules. PPO plans (Blue Shield PPO, Blue Cross PPO) allow direct access to podiatrists without a referral. BCN (Blue Care Network) HMO plans require a referral from your PCP. State of Michigan employee BCBS plans, UAW retiree BCBS/VEBA plans, and Medicare Plus Blue PPO are all accepted at Balance Foot & Ankle. All medically necessary podiatric care is covered under standard specialist benefits.
Aetna, United Healthcare, Cigna, Humana
All four major national commercial insurers cover medically necessary podiatric care. PPO plans (Aetna PPO, UHC Choice Plus, Cigna Open Access, Humana PPO) typically do not require referrals. HMO plans may require PCP referrals. Cost-sharing depends on your specific plan’s deductible and copay structure — typically $30–$60 specialist copay after meeting your deductible. We verify your specific benefits before your appointment.
Michigan Medicaid Plans (Meridian, Priority Health, McLaren)
Michigan Medicaid (Healthy Michigan Plan) covers medically necessary podiatric services through managed care organizations. Meridian Health Plan, Priority Health Medicaid, and McLaren Health Plan all cover podiatry. Patient cost-sharing is minimal — typically $0–$3 per visit. Some Medicaid plans require a referral from your primary care provider. Balance Foot & Ankle accepts most Michigan Medicaid managed care plans.
What Insurance Covers vs. What Requires Documentation
Always covered (no special documentation needed): any symptomatic foot condition requiring diagnosis or treatment — heel pain, bunions, ingrown toenails, ankle injuries, fractures, infections, wounds, fungal nails (treatment), and nerve conditions.
Requires qualifying condition documentation: routine nail trimming and callus removal are covered when you have diabetes, neuropathy, peripheral artery disease, chronic venous insufficiency, or other systemic conditions. Without documentation of a qualifying condition, routine nail care is not covered by most insurers.
Requires pre-authorization: some procedures require prior approval — custom orthotics (commercial plans), surgical procedures (elective), and advanced therapies like EPAT shockwave (some plans).
Do I Need a Referral?
Usually no — especially for PPO plans. The majority of our patients come directly without a referral. HMO plans (BCN, HAP HMO, McLaren HMO, some Medicaid plans) typically require a referral from your primary care doctor. If you’re unsure, call us and we’ll tell you exactly what your plan requires before your visit.
What You Should Do Right Now
Don’t try to figure out your coverage alone — insurance benefit language is complex and varies by plan year. Our front desk team verifies benefits before every appointment at no charge. We’ll tell you exactly what your plan covers, what your out-of-pocket cost will be, and whether a referral is needed — before you ever arrive.
Frequently Asked Questions
Does my insurance cover custom orthotics?
Usually yes, with proper documentation of medical necessity. Coverage amounts vary widely by plan — from full coverage to a flat benefit (e.g., $200 toward custom orthotics). We verify before prescribing.
Does insurance cover laser treatments (MLS, toenail fungus)?
MLS laser for wound healing and pain is covered by many plans. Toenail fungus laser is typically not covered and is available self-pay. EPAT shockwave varies — some plans cover it, some don’t. We verify before scheduling.
What if I have no insurance?
We offer transparent self-pay pricing. Ask about our rates at (810) 206-1402.
I have Medicare and a supplemental plan — what do I pay?
With Medicare Part B plus a Medigap supplement, most patients pay $0 for covered services after meeting the Part B deductible.
Not sure what your plan covers? Our team verifies your insurance before every visit — no surprise bills, no confusion.
📞 (810) 206-1402 | Howell: 4330 E Grand River Ave | Bloomfield Township: 43494 Woodward Ave #208
We accept Medicare, Medicare Advantage, BCBS, Aetna, United Healthcare, Cigna, Humana, HAP, Meridian, Priority Health, Oscar, McLaren, Workers’ Comp, VA, and most Michigan insurance plans.
📞 Call (810) 206-1402 to verify your coverage — we’ll tell you exactly what you’ll pay before your appointment.
Michigan patients experiencing foot or ankle problems can schedule an appointment at Balance Foot & Ankle — with locations in Howell (4330 E Grand River) and Bloomfield Township (43494 Woodward Ave #208). Call (810) 206-1402 for same-week availability.
Related Treatment Guides
- Plantar Fasciitis & Heel Pain Treatment
- Custom 3D Orthotics
- Sports Foot & Ankle Injury Treatment
- Bunion Treatment
Medical References & Sources
- American Podiatric Medical Association — Patient Education
- American Orthopaedic Foot & Ankle Society — Foot Conditions
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Township Office
43494 Woodward Ave, #208
Bloomfield Township, MI 48302
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Your Board-Certified Podiatrists
Ready to Get Back on Your Feet?
Same-week appointments available at both locations.
Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Township. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Book Today — Same-Day Appointments Available
Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Township, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Visit Balance Foot & Ankle — Same-Day Appointments Available
Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Township. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.
Same-day appointments available. (810) 206-1402
Doctor Hoy’s Natural Pain Relief Gel
Natural topical pain relief I use in our clinic. Arnica + camphor formula — apply directly to the area 3–4x daily. ($20–25)
Related Care at Balance Foot & Ankle
Clinical foot and ankle services at our Howell and Bloomfield Township offices.
Get Expert Care at Balance Foot & Ankle
Same-week appointments at our Howell and Bloomfield Township offices. Board-certified podiatric surgeons. Most insurance accepted.
Ready for Expert Care?
Same-day appointments in Howell & Bloomfield Township, MI.
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Or call: (810) 206-1402
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.
More questions patients ask
Does Medicare cover podiatry visits in Michigan?
Yes — Medicare Part B covers medically necessary podiatric care. Covered services include: treatment of foot injuries and diseases (plantar fasciitis, infections, wounds, fractures); foot exams for diabetics with neuropathy or vascular disease; surgical procedures; and foot X-rays. Medicare generally does NOT cover routine foot care (nail trimming, callus removal) UNLESS you have a systemic condition like diabetes, peripheral neuropathy, or poor circulation that makes self-care hazardous. You pay 20% of the Medicare-approved amount after your Part B deductible.
What podiatry services does Medicare pay for?
Medicare-covered podiatry services: treatment of bunions, hammer toes, plantar fasciitis, heel spurs, ankle sprains; diabetic foot exams and wound care; orthotics and custom shoes for diabetics; removal of painful ingrown toenails; surgery for foot and ankle conditions; nerve blocks and injections; and X-rays. Routine nail trimming is only covered when you have a systemic condition (diabetes, neuropathy, PAD, lymphedema). Balance Foot & Ankle accepts Medicare at both Howell and Bloomfield Township locations — call (810) 206-1402.
How often does Medicare cover a podiatry visit?
Medicare covers podiatry visits as often as medically necessary — there's no fixed annual limit for treatment of conditions. For routine foot care in diabetics, Medicare covers one foot exam every 6 months, or more frequently if there's documented change in condition. You must see your prescribing physician (for the systemic condition) within the prior 6 months to qualify for routine care coverage. Balance Foot & Ankle will help verify and document your coverage before treatment.
Does Medicare Advantage cover podiatry in Michigan?
Most Medicare Advantage plans (Part C) cover podiatry equivalent to or better than Original Medicare. Some plans offer $0 or low copays for podiatry visits, additional benefits like routine foot care for non-diabetics, and lower out-of-pocket costs. Coverage details vary significantly by plan. Balance Foot & Ankle is in-network with most major Medicare Advantage plans in Michigan. Call (810) 206-1402 — our staff will verify your specific Advantage plan benefits before your appointment.
What podiatry services are covered by Medicare Part B?
Medicare Part B covers podiatry services for medically necessary conditions including diabetic foot exams, wound care, treatment of foot infections, bunion surgery, fracture care, ankle tendon repair, and nail care for patients with systemic disease. Routine foot care without documented medical necessity is generally excluded.
Does Medicare pay 100% for podiatry visits?
Medicare Part B pays 80% of the approved amount after the annual deductible. You're responsible for the remaining 20% coinsurance unless you have supplemental insurance (Medigap) or a Medicare Advantage plan that covers cost-sharing. Balance Foot & Ankle's billing team verifies all benefits beforehand. Call (810) 206-1402.
Can a podiatrist order Medicare-covered diabetic foot exams?
Yes, podiatrists like Dr. Tom Biernacki DPM, Dr. Carl Jay DPM, and Dr. Daria Gutkin DPM at Balance Foot & Ankle can order and perform Medicare-covered annual comprehensive diabetic foot exams. These exams are essential for preventing diabetic complications including ulcers and amputations.
Does Medicare cover podiatry at both Balance Foot & Ankle locations?
Yes, Balance Foot & Ankle accepts Medicare at both locations — 4330 E Grand River in Howell and 43494 Woodward Ave #208 in Bloomfield Township. Call (810) 206-1402 to schedule a Medicare-covered podiatry appointment at the location most convenient for you.
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.