Michigan Podiatry: Insurance Accepted and Coverage Guide
Understanding Your Insurance Coverage for Podiatry in Michigan
One of the most common questions patients ask before their first visit is: “Will my insurance cover this?” The answer depends on your specific plan, your diagnosis, and the type of service being performed. This guide explains how podiatric care is covered under major insurance types, what Balance Foot & Ankle accepts, and how to get the most from your benefits.
Does Insurance Cover Podiatry?
Yes — in most cases, podiatric care is covered when it is medically necessary. Routine foot care (such as nail trimming in non-diabetic patients) is often excluded from coverage, but the vast majority of services a podiatrist provides — treating plantar fasciitis, bunions, ingrown toenails, ankle fractures, diabetic foot complications, and prescribing orthotics — are considered medically necessary and covered by most insurance plans.
Major Insurance Types We Accept
Blue Cross Blue Shield of Michigan: Balance Foot & Ankle is in-network with most BCBS Michigan plans, including PPO and HMO options. BCBS covers a wide range of podiatric services including office visits, X-rays, procedures, and custom orthotics with appropriate diagnosis codes.
Medicare: We accept Original Medicare (Parts A and B). Medicare covers medically necessary podiatric services including treatment of foot conditions related to systemic diseases (diabetes, peripheral vascular disease, neuropathy), nail procedures, fracture care, and surgical procedures. Medicare also covers therapeutic diabetic footwear (one pair of shoes plus three pairs of inserts per year) for eligible diabetic patients.
Medicaid / Healthy Michigan Plan: We accept Michigan Medicaid and the Healthy Michigan Plan for qualifying patients. Covered services vary by plan; our billing team verifies benefits before your appointment.
Aetna, Cigna, United Healthcare, Humana: We are in-network with most major commercial carriers. Coverage varies by plan tier (HMO, PPO, EPO) and employer group. Our front desk verifies your specific benefits before your visit.
Workers Compensation: Foot and ankle injuries sustained on the job are covered under Michigan workers compensation. We accept workers comp cases and work directly with adjusters to streamline your care.
Auto No-Fault Insurance: Foot and ankle injuries from motor vehicle accidents are covered under Michigan No-Fault auto insurance. We handle the billing process for no-fault cases.
Do I Need a Referral?
Most insurance plans do not require a referral to see a podiatrist. PPO plans generally allow direct specialist access without a referral. Some HMO plans require a referral from a primary care physician. Our front desk will confirm whether your specific plan requires one when you call to schedule. In many cases, even HMO patients can be seen urgently without a referral for acute injuries.
Custom Orthotics and Insurance
Custom orthotics are covered by most commercial insurance plans and Medicare when prescribed by a podiatrist for a diagnosed medical condition. Common covered diagnoses include plantar fasciitis, flat feet, diabetic neuropathy, and post-surgical support. Our office handles all documentation and prior authorization requirements. Medicare covers diabetic orthotics under the therapeutic shoe benefit separately from standard orthotic coverage.
What You Can Expect to Pay
Your out-of-pocket costs depend on your specific plan’s deductible, copay, and coinsurance structure. Common costs include a specialist copay for office visits ($20 to $60 for most commercial plans), coinsurance after your deductible for procedures and surgery, and a potential cost share for custom orthotics. Our billing team provides a cost estimate before any elective procedure.
Self-Pay and Uninsured Patients
Balance Foot & Ankle welcomes self-pay patients. We offer transparent pricing for common services and payment plan options for larger procedures. Contact our office to discuss self-pay rates before your appointment.
How to Verify Your Benefits
Call the member services number on the back of your insurance card and ask: “Is Balance Foot & Ankle in-network?” and “What is my specialist copay and deductible?” Alternatively, call our office and our billing team will verify your benefits as a complimentary service before your first visit.
Contact Balance Foot & Ankle
We make insurance as easy as possible. Our staff handles pre-authorizations, referral coordination, and claims submission so you can focus on getting better. Call us at (810) 206-1402 or schedule online at any of our Michigan locations.
Insurance Coverage Questions for Michigan Podiatry: Talking to Balance Foot & Ankle
Michigan patients with questions about their specific insurance coverage for podiatric services — deductible status, copay amounts, whether a specific procedure is covered, and whether a referral is needed — can call Balance Foot & Ankle at (810) 206-1402 and speak directly with our insurance verification team before scheduling. We verify benefits for every new patient before their appointment and provide a clear explanation of anticipated cost responsibility. For patients with high-deductible plans early in the calendar year, we discuss realistic cost expectations upfront. For patients who have been told a service is “not covered” by a previous provider and are surprised, we sometimes find that the service is covered under a different billing code or with appropriate documentation of medical necessity — it’s worth a call to verify rather than assuming. Balance Foot & Ankle is in-network with Blue Cross Blue Shield of Michigan, Aetna, UnitedHealthcare, Cigna, Medicare, and most Medicare Advantage plans in the Livingston and Oakland County markets. Our team can verify your specific plan and provide the information you need to make an informed scheduling decision.
Related Treatment Guides
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.
Related Patient Guides
- Insurance & Costs at Balance Foot & Ankle
- Medicare Diabetic Shoe Benefit
- Your First Visit to Balance Foot & Ankle
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.
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon 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 reached over one million views.