Insurance Accepted at Balance Foot & Ankle | Michigan Podiatrist

Quick answer: Insurance Accepted Balance Foot Ankle Michigan Podiatrist is a common foot/ankle topic that affects many patients. The 2026 evidence-based approach combines proper diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Hills practices. Call (810) 206-1402.

Navigating insurance for podiatric care shouldn’t be stressful. At Balance Foot & Ankle, our front office team handles insurance verification before your first appointment so there are no surprises. We work with the vast majority of Michigan insurance carriers and participate as in-network providers with the plans listed below.

Our three board-certified podiatrists—Dr. Carl Jay, DPM, Dr. Daria Gutkin, DPM, and Dr. Tom Biernacki, DPM—see patients at our Howell and Bloomfield Hills offices. Both locations accept the same insurance plans.

Insurance Plans We Accept

Balance Foot & Ankle is in-network with the following insurance plans. This list is updated regularly but may not reflect the most recent changes. If your plan is not listed, please call us—we frequently add new plans and may still be able to see you.

Major National Plans

• Medicare (Parts A & B) — We are Medicare-participating providers
• Blue Cross Blue Shield (BCBS) — PPO, HMO, and Medicare Advantage plans
• Aetna — PPO, HMO, POS, and Medicare Advantage
• UnitedHealthcare (UHC) — PPO, HMO, and Medicare Advantage (including AARP Medicare Complete)
• Cigna — PPO, HMO, and Open Access Plus
• Humana — PPO, HMO, and Medicare Advantage
• Anthem — PPO and HMO plans

Michigan-Specific Plans

• HAP (Health Alliance Plan) — HMO, PPO, and Medicare Advantage
• Priority Health — HMO, PPO, and Medicare Advantage
• McLaren Health Plan — HMO and Medicare Advantage
• Meridian Health Plan — Medicaid and Medicare-Medicaid plans
• Molina Healthcare — Medicaid plans
• PHP (Physicians Health Plan)
• Total Health Care

Other Accepted Plans

• Tricare (military/veterans)
• Medicare Supplement (Medigap) — Plans A through N
• Workers’ Compensation
• Auto No-Fault (PIP) — Michigan auto accident coverage
• Cofinity / PPOM
• Great-West Healthcare
• MultiPlan / PHCS

Medicare Coverage for Podiatry

Medicare Part B covers medically necessary podiatric services, and Balance Foot & Ankle is a Medicare-participating provider. This means we accept Medicare’s approved amount as full payment, and you are only responsible for your 20% coinsurance (after your annual deductible is met) and any applicable copayments. If you have a Medicare Supplement (Medigap) plan, it typically covers part or all of that remaining 20%.

Medicare Covers

• Routine foot care for qualifying conditions: If you have diabetes with peripheral neuropathy, peripheral vascular disease, or other systemic conditions that put your feet at risk, Medicare covers routine nail trimming, callus debridement, and foot examinations every 61 days
• Diagnosis and treatment of foot conditions: Plantar fasciitis, bunions, hammertoes, heel spurs, Morton’s neuroma, stress fractures, tendonitis, arthritis, and other medical conditions of the foot and ankle
• Diabetic shoes and custom inserts: The Medicare Therapeutic Shoe Program provides one pair of diabetic shoes and three pairs of inserts per calendar year for qualifying diabetic patients
• Surgery: Medically necessary foot and ankle surgeries including bunion correction, hammertoe repair, neuroma excision, ingrown toenail procedures, and fracture fixation
• X-rays and diagnostic imaging: When medically necessary to diagnose or monitor a foot condition

Medicare Typically Doesn’t Cover

• Routine foot care (nail trimming, callus removal) for patients without a qualifying systemic condition
• Orthotics and custom shoe inserts (unless through the Diabetic Shoe Program)
• Cosmetic procedures
• Experimental treatments

Blue Cross Blue Shield

Blue Cross Blue Shield of Michigan is the most common private insurance in our area, and we are fully in-network with BCBS PPO, HMO, and Medicare Advantage plans. BCBS typically provides excellent coverage for podiatric services including office visits, diagnostic imaging, in-office procedures, and surgery. Your specific copay, coinsurance, and deductible depend on your particular plan. Our office will verify your benefits before your first visit so you know exactly what to expect.

BCBS plans in Michigan generally cover the same podiatric services as Medicare—diagnosis and treatment of foot and ankle conditions, medically necessary surgery, and diagnostic imaging. Many BCBS plans also cover custom orthotics (with a prescription and documented medical necessity) and physical therapy for foot and ankle rehabilitation.

What Podiatric Services Does Insurance Cover?

Most insurance plans cover medically necessary podiatric care—meaning treatment for a diagnosed foot or ankle condition that requires professional attention. Here’s what’s typically covered and what may require pre-authorization.

Usually Covered Without Pre-Authorization

• Office visits for evaluation and diagnosis of foot and ankle conditions
• X-rays and diagnostic ultrasound
• Treatment of ingrown toenails (including partial nail avulsion)
• Wound care for diabetic foot ulcers
• Corn and callus debridement (for patients with qualifying conditions)
• Injections (corticosteroid, local anesthetic)
• Casting and splinting for fractures
• Prescriptions for medications

May Require Pre-Authorization

• Foot and ankle surgery (bunion correction, hammertoe repair, fracture fixation)
• MRI and advanced imaging
• Custom orthotics (coverage varies significantly by plan)
• Durable medical equipment (walking boots, braces)
• Physical therapy referrals

Our office handles pre-authorization requests for all procedures and imaging. If pre-authorization is needed, we submit the request to your insurance company with all required clinical documentation and notify you once approval is received. We do not proceed with pre-authorization-required services until approval is confirmed.

What Insurance Typically Doesn’t Cover

While coverage varies by plan, the following services are commonly excluded or limited by most insurance policies.

• Routine foot care without a qualifying condition: Nail trimming, callus removal, and foot maintenance for patients without diabetes, neuropathy, or vascular disease are generally considered preventive/cosmetic and not covered
• Cosmetic procedures: Surgery performed solely for appearance (such as toe shortening without a functional complaint)
• Over-the-counter insoles and shoe inserts: Only custom-molded orthotics prescribed for a diagnosed condition are potentially covered
• Shoes: Regular footwear is not covered (exception: diabetic therapeutic shoes through Medicare)
• Laser treatment for toenail fungus: Most plans consider this experimental and do not cover it
• Experimental or investigational treatments: Treatments not yet recognized as standard of care

How We Verify Your Insurance

When you schedule your first appointment at Balance Foot & Ankle, our front office team will collect your insurance information and verify your benefits before your visit. This process confirms that your plan is active, identifies your copay, deductible, and coinsurance amounts, checks whether a referral is required from your primary care physician, and determines if any pre-authorization is needed for your anticipated services.

We do this verification work so you can focus on your health, not paperwork. If there are any issues with your coverage or if your out-of-pocket costs will be higher than expected, we’ll contact you before your appointment to discuss your options. There are no surprise bills at Balance Foot & Ankle.

What to Bring to Your First Visit

• Insurance card (front and back)
• Photo ID (driver’s license or state ID)
• Referral from your primary care physician (if your plan requires one)
• List of current medications
• Any previous imaging (X-rays, MRIs) related to your foot or ankle condition
• Completed new patient forms (available on our New Patient page or can be completed in-office)

No Insurance? We Can Still Help

We believe everyone deserves access to quality foot and ankle care. If you don’t have insurance, we offer competitive self-pay rates that are often comparable to or less than insurance copays at other practices. We also offer payment plans for larger procedures so cost doesn’t have to be a barrier to getting the care you need.

For self-pay patients, we provide upfront pricing so you know exactly what your visit will cost before you arrive. A new patient evaluation (including X-rays if needed) is affordably priced, and many in-office procedures (ingrown toenail treatment, corn debridement, injections) can be completed during the same visit at transparent, pre-discussed pricing.

Frequently Asked Questions

Do I need a referral to see a podiatrist?

It depends on your insurance plan. PPO plans generally do not require a referral—you can schedule directly with our office. HMO plans typically do require a referral from your primary care physician before seeing a specialist, including a podiatrist. When you call to schedule, our team will check your plan’s referral requirements and let you know. If a referral is needed, we can often help coordinate it with your PCP’s office to streamline the process.

Does insurance cover custom orthotics?

Coverage for custom orthotics varies significantly by plan. Many PPO plans provide partial or full coverage for custom orthotics when prescribed by a podiatrist for a documented medical condition (plantar fasciitis, diabetic foot, posterior tibial tendon dysfunction, etc.). Some plans limit orthotics to one pair per year or per lifetime. Medicare does not cover standard custom orthotics but does cover diabetic inserts through the Therapeutic Shoe Program. Our billing team will verify your specific orthotic coverage and discuss your options before ordering.

Does Medicare cover toenail trimming?

Medicare covers routine foot care—including toenail trimming and callus debridement—when you have a qualifying systemic condition that puts your feet at increased risk. The most common qualifying conditions are diabetes with peripheral neuropathy and peripheral vascular disease. Under these conditions, Medicare covers foot care visits every 61 days (approximately every 2 months). Without a qualifying condition, routine nail trimming is considered preventive and is not covered by Medicare. If you’re unsure whether you qualify, our office can evaluate you and determine eligibility.

What if my insurance denies a claim?

Insurance denials, while frustrating, are not uncommon—and they’re often reversible. Our billing department handles insurance appeals as a standard part of our practice operations. If a claim is denied, we review the reason, gather any additional documentation needed, and submit a formal appeal on your behalf. Common reasons for denial include missing referral (easily corrected), lack of pre-authorization (we resubmit with required documentation), and incorrect coding (we correct and resubmit). The vast majority of legitimate denials are overturned on appeal. You are never left to navigate the appeals process alone.

When Shoes Aren’t Enough — Dr. Tom’s Top 9 Orthotics

About 30% of patients I see for foot pain need MORE than a great shoe — they need a structured insole. Below: my complete 2026 orthotic ranking with pros, cons, and the specific patient I’d give each one to.

Visit Balance Foot & Ankle — Same-Day Appointments Available

Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Hills. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.

Frequently Asked Questions

When should I see a podiatrist?

If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).

What does treatment cost?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.

American Podiatric Medical Association: Find a Podiatrist

How quickly can I get an appointment?

Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.

Related Care at Balance Foot & Ankle

Clinical ankle services at our Howell and Bloomfield Hills offices.

Ankle Sprain & InstabilityFoot BracingAnkle Arthroscopy