Medicare Diabetic Shoe Benefit in Michigan: What’s Covered and How to Get It

Quick answer: Medicare Diabetic Shoe Benefit Michigan is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Hills practices. Call (810) 206-1402.

Related Conditions

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

What Is the Medicare Therapeutic Shoe Benefit?

The Medicare Therapeutic Shoe Benefit is a Medicare Part B benefit specifically for patients with diabetes mellitus who are at risk of serious foot complications. If you have diabetes and are enrolled in Medicare Part B, you may qualify for significant help covering the cost of therapeutic diabetic shoes and inserts — at little to no out-of-pocket cost. This benefit exists because diabetic foot ulcers, amputations, and hospitalizations cost the healthcare system billions per year, and proper footwear dramatically reduces that risk.

What the Medicare Diabetic Shoe Benefit Covers

Each calendar year, Medicare Part B covers ONE of the following options for qualifying diabetic patients: one pair of custom-molded shoes (made from a plaster cast or 3D scan of your foot) plus two additional pairs of custom-molded inserts, OR one pair of extra-depth shoes (shoes with extra vertical depth to accommodate inserts and deformities) plus three pairs of custom-molded inserts. Medicare pays 80% of the approved amount after your Part B deductible. A Medigap supplement typically covers the remaining 20%. Total shoe benefit value: $350–$800 per year depending on shoe type and inserts selected.

Who Qualifies for the Medicare Diabetic Shoe Benefit

To qualify, you must: be enrolled in Medicare Part B; have diabetes mellitus (Type 1 or Type 2); have at least one of the following foot conditions: peripheral neuropathy with evidence of callus formation, history of pre-ulcerative calluses, history of previous foot ulceration, history of partial or complete foot amputation, foot deformity (bunions, hammertoes, Charcot foot), or poor circulation (peripheral arterial disease affecting the foot. Your treating physician or podiatrist must certify that you have diabetes and one of the qualifying conditions. The shoes must be prescribed and provided by a Medicare-enrolled podiatrist, orthotist, prosthetist, or pedorthist — not a shoe store.

How to Get Your Medicare Diabetic Shoes in Michigan

Step 1: Schedule an appointment with Dr. Tom Biernacki at Balance Foot & Ankle. He will evaluate your diabetic foot status and certify eligibility. Step 2: Your certifying physician (primary care or endocrinologist) must document your diabetes management in a plan of care — this is often already part of your annual visit records. Step 3: Dr. Biernacki will measure your feet, evaluate your deformities and gait, and prescribe the appropriate shoe type and insert modifications (metatarsal pads, heel wedges, toe filler, etc.). Step 4: Shoes are ordered through an enrolled Medicare supplier. Step 5: You receive your shoes and inserts — typically within 2–4 weeks. Step 6: The cycle resets each January 1 — you can receive a new benefit annually.

What to Bring to Your Diabetic Shoe Appointment

Bring your Medicare card and any supplemental insurance card (Medigap or Medicare Advantage); your most recent HbA1c lab result if available; a list of current medications; your current shoes (the ones you walk in most) — we look for wear patterns; and any records of previous foot ulcers, amputations, or hospitalizations. The appointment typically takes 45–60 minutes and includes a thorough diabetic foot exam, which is separately covered by Medicare Part B (as a preventive service for patients with diabetes-related nerve damage).

What Is NOT Covered Under the Diabetic Shoe Benefit

The diabetic shoe benefit does not cover: more than one pair of shoes per calendar year; shoes purchased at a regular shoe store or pharmacy (not through an enrolled Medicare supplier); over-the-counter insoles or prefabricated inserts (must be custom-molded); shoes that do not meet Medicare’s therapeutic shoe specifications; the benefit in the same year as a below-the-knee amputation on that leg (different rules apply post-amputation for prosthetics). Additionally, Medicare Advantage plans may have different rules — some cover additional shoe benefits, others may restrict to specific suppliers.

Schedule Your Diabetic Shoe Evaluation

Dr. Tom Biernacki evaluates and prescribes Medicare diabetic shoes and inserts at Balance Foot & Ankle in Howell (4330 E Grand River Ave) and Bloomfield Hills. We are enrolled Medicare providers. Call (810) 206-1402 to schedule your diabetic foot evaluation and shoe benefit appointment. Most patients pay $0 out of pocket with Medicare plus a Medigap supplement. For full insurance information, see our podiatrist insurance and costs Michigan page.

Frequently Asked Questions

Dr. Tom Biernacki, DPM is a board-certified podiatric surgeon and diabetic foot care specialist at Balance Foot & Ankle in Howell and Bloomfield Hills, Michigan. He is a Medicare-enrolled provider for diabetic therapeutic shoes and preventive foot care services.

Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)

If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.

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-day evaluations and advanced in-office care.

Frequently Asked Questions

Why is diabetic foot care so important?

Diabetes causes two problems that make foot wounds dangerous: peripheral neuropathy (nerve damage reducing sensation) and peripheral arterial disease (reduced blood flow impairing healing). A small blister or cut that a non-diabetic person would notice and treat can go undetected in a diabetic patient for days, become infected, and progress to osteomyelitis. Diabetic foot ulcers are the leading cause of non-traumatic lower limb amputations. A consistent foot care routine and regular podiatry visits prevent most amputations.

How often should diabetic patients see a podiatrist?

Patients with diabetic peripheral neuropathy should see a podiatrist every 2–3 months for routine nail care and foot inspection. Patients with active foot complications (ulcers, Charcot foot, severe PAD) need more frequent visits — often every 2–4 weeks until stable. Even well-controlled diabetics without neuropathy benefit from annual foot exams. Many amputations we see in consultation could have been prevented with earlier, consistent podiatric care.

What is diabetic peripheral neuropathy?

Peripheral neuropathy is nerve damage from chronically elevated blood sugar, causing numbness, tingling, burning, or loss of sensation — typically starting in the toes and progressing upward in a ‘stocking’ distribution. The dangerous aspect isn’t the pain — it’s the absence of pain. Patients with severe neuropathy don’t feel blisters, cuts, pressure sores, or early infections. A wound can reach bone before it’s noticed. Neuropathy screening with a 10-gram monofilament is part of every diabetic foot exam.

What are the warning signs of a diabetic foot problem?

Seek same-day evaluation for: any open wound or blister that isn’t healing within 1–2 weeks, redness, warmth, or swelling in any part of the foot (possible Charcot fracture or infection), a new blister or callus, any red streaking or warmth spreading up the leg (cellulitis), foot or ankle pain in a diabetic patient with neuropathy (could be Charcot without pain). Don’t wait to see if it improves — diabetic foot infections are medical emergencies.

What is the best foot cream for diabetic feet?

The goal of diabetic foot cream is restoring the skin’s moisture barrier to prevent fissuring and cracking — the entry points for infection. Look for urea-based creams (10–25% urea) or lactic acid formulations that actually penetrate thickened skin rather than sitting on the surface. AmLactin 12%, Eucerin Diabetics’ Dry Skin Relief, and Gold Bond Diabetics’ Dry Skin Relief are clinical-grade options. Avoid cream between the toes — moisture retention between toes promotes maceration and fungal infection.

Can diabetic patients get foot massages?

Light massage is generally safe for diabetic patients without active wounds, severe edema, or PAD. However, deep tissue massage or vigorous rubbing should be avoided — with neuropathy, patients can’t feel if tissue is being damaged. Foot massagers with rollers or intense vibration should be avoided entirely. If you enjoy foot massage, use gentle, light strokes with a diabetic-appropriate foot cream. Let your podiatrist know if you’re incorporating massage into your routine — we can advise based on your circulation status.

What type of socks should diabetic patients wear?

Diabetic socks: seamless (seams can create pressure sores over a neuropathic foot), non-binding at the top (circulation-restrictive socks worsen PAD), moisture-wicking (polyester/wool blend reduces bacterial environment), padded sole (cushions bony prominences). Avoid cotton socks for active patients — cotton retains moisture. Never wear socks with elastic bands that leave marks on the leg. Brands specifically designed for diabetic feet: Thorlos, Wigwam, and most major medical supply brands.

Should diabetic patients cut their own toenails?

It depends on neuropathy severity and vision. Patients with mild neuropathy and good vision can safely trim nails straight across without cutting the corners. Patients with moderate-to-severe neuropathy, poor vision, or thick nails should not self-trim — the risk of cutting the surrounding skin (which they may not feel) is too high. This is exactly what podiatry nail care visits are for. Medicare and most insurance plans cover routine foot care for diabetic patients with documented neuropathy.

What is Charcot foot and how serious is it?

Charcot neuroarthropathy is a serious diabetic complication where neuropathy allows repeated micro-fractures to occur without pain, leading to progressive bone and joint destruction and foot deformity. The classic presentation: a warm, swollen, red foot in a diabetic patient — often mistaken for cellulitis. Early Charcot (caught within weeks of onset) can be managed with a total contact cast to prevent further collapse. Late Charcot with significant arch destruction often requires reconstructive surgery. Missing the diagnosis is catastrophic — a single patient with missed Charcot can progress to a rocker-bottom deformity requiring amputation.

Does insurance cover diabetic foot care?

Medicare Part B covers routine foot care (nail trimming, callus debridement) for diabetic patients with documented peripheral neuropathy — one visit every 2 months. Most PPO and HMO plans follow similar coverage rules. Diabetic shoes and insoles are covered under Medicare’s Therapeutic Shoe Bill (one pair of shoes plus three pairs of custom insoles per year). Call us at (810) 206-1402 and we’ll verify your specific coverage before your first appointment.