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 Hills 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.

Does Medicare cover podiatry visits in Michigan?

Yes, Medicare Part B covers medically necessary podiatry services in Michigan. This includes treatment of foot injuries, infections, foot conditions caused by systemic disease (diabetes, peripheral neuropathy, PAD), and podiatric surgery. Balance Foot & Ankle in Howell and Bloomfield Hills accepts Original Medicare and Medicare Advantage.

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 Hills. Call (810) 206-1402 to schedule a Medicare-covered podiatry appointment at the location most convenient for you.

When should I see a podiatrist?

For persistent foot/ankle pain, difficulty walking, numbness, non-healing wounds, skin changes, or deformities. Dr. Biernacki offers same-day appointments. Call 810-206-1402.

Does Dr. Biernacki accept insurance?

Balance Foot & Ankle accepts most major plans including BCBS, Aetna, United, Cigna & Medicare. Call 810-206-1402 to verify coverage. Affordable self-pay options available.

What to expect at your first podiatry visit?

Comprehensive evaluation including history, exam, biomechanical assessment, and in-office X-rays. Same-day diagnosis and treatment when possible. Most visits take 30-45 minutes.

Does Insurance Cover a Podiatrist in Michigan? Complete Guide (All Insurers)

✅ YES — Podiatry Is Covered by Virtually All Insurance Plans
Medicare, Medicaid, BCBS, Aetna, United Healthcare, Cigna, Humana, HAP, Molina, 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
Molina Healthcare	✅ Yes (Medicaid/Marketplace)	May require referral	Low/$0 for qualifying
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 (Molina, Meridian, Priority Health, McLaren)

Michigan Medicaid (Healthy Michigan Plan) covers medically necessary podiatric services through managed care organizations. Molina Healthcare, 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.

✅ Free Insurance Verification
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 Hills: 43494 Woodward Ave #208
We accept Medicare, Medicare Advantage, BCBS, Aetna, United Healthcare, Cigna, Humana, HAP, Molina, 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 Hills (43494 Woodward Ave #208). Call (810) 206-1402 for same-week availability.

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📍 Located in Michigan?

Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.

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Insurance Accepted

BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →

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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Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

Ready to Get Back on Your Feet?

Same-week appointments available at both locations.

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(810) 206-1402