What does Medicaid pay for Diabetic shoes in each state?

Answer 1

As a Medicare and Medicaid diabetic shoe supplier in Colorado, there are provisions for shoes to be supplied to individuals with Diabetes. Since MedicAID is a joint federal-state funded program for the indigent that is run by each state, there can be variations in the benefits provided in each state. Capitalizing AID and ARE is emphasis so readers will be made aware of which program is being referred.

But typically if MedicARE (federal healthcare program for elderly and individuals that are unable to work due to a permanent injury) provides for an item or service, then the state MedicAID program will also supply but with the state's limits imposed. MedicARE benefit is for one pair of shoes and three pair of inserts per calendar year. Since a person can be dropped out of MedicAID if their income exceeds a certain level, Colorado's MedicAID program does not pay for 3 pair of inserts for a year's use as that person may be dropped from the MedicAID rolls the following quarter due to their income increasing.

Therapeutic shoes for diabetes as a MediCARE benefit is 80% covered by MediCARE. If the individual has a secondary policy that does cover the other 20%, then there could be no out of pocket cost (except for annual deductible if deductible has not already been met). So it is inappropreate to refer to "free" Medicare diabetic shoes. MediCAID in Colorado has $1.00 copayment.

The MedicARE specifications for therapeutic shoes for diabetes is that shoes must be available from the manufacturer in half sizes, minimum of 3 widths, have lace or Velcro strap closure design, upper of leather or equivalent material, and have a removable insole of a thickness that creates space for the diabetic insole to go. Most shoes that are used in the MedicARE and MedicAID programs are referred to as depth shoes due to the thicker insole design creating a roomier toe box for hammer toes or overlapping toes.

Newer styles from manufacturers that have a focus on diabetes market often look like standard shoes (casual, walking, athletic, and even dress casual). Indeed, retail businesses that sell shoes to customers as well as supply diabetic shoes will ofter be using the same shoes. A retail customer with hammer toes who does not have diabetes may need the same shoe that the individual with diabetes and hammer toes.

So the term "diabetic shoe" really means a properly fit, good shoe that meets the standards of the primary healthcare plan that offers that benefit, MedicARE.

The original legislation to create the Therapeutic Shoe for Diabetes benefit from MedicARE dates back to 1993. In this legislation, the suppliers that were designated as qualified to dispense or supply this benefit were listed as podiatrists, orthotists, prosthetists, and pedorthists. A reference was made in law to "or other qualified providers" which has allowed pharmacists to start dispensing shoes. Of all the individuals deemed qualified, only pedorthists are actually specialists in footwear and shoe fitting.

Not all pedorthists, however, have businesses or work at businesses that supply diabetic shoes. Some pedorthists specialize in custom foot orthotics or work at retail shoe stores. But those pedorthists that do focus on the supply of diabetic shoes feel that their expertise is more focused on footwear than the other practitioners.

Since one of the major reasons for using diabetic shoes to prevent foot complications that lead to amputation is foot deformities (bunions, hammer toes, claw toes, elevated toes, overlapping toes, collapsed arches, very high arches, etc.), it is very useful for the supplier of diabetes shoes to have fitting inventory on-site. One can measure a foot and bring out a shoe size and style that should fit . . . . and the toe box rubs an elevated toe. So the practitioner needs to go try a half size longer or a size wider. Those suppliers that order in one pair of shoes based on measuring can find that the shoes ordered are not right.

There is some debate as to how important fitting inventory (complete size runs in 3 widths of three different lasts (shape of shoe) is to accurate fitting. But if the supplier is truly taking care of feet that need protection, it is hard to image how a supplier that wants to be as precise as possible could do well by every individual by using a catalog instead of fitting inventory.

Answer 2

Yes it does. It also covers the cost of glucose meter and other supplies along with medicine. I'm not sure if it covers insulin used by diabetics patients though. (Don't mind: You should ask this question to doctor or medicat office to get accurate, fast and confidential response).

Source:

Mediat user.

Answer 3

No. They are actually considered DME. MS Medicaid does not cover DME unless the patient is under 18 years of age.

Answer 4

It pay over 30,000 in each state. If you want to make sure I am correct go to WWW. GEODODGE .COM Type in Diabetic shoes