While Medicare will cover custom orthotics up to 80% of the cost, patients must meet very specific requirements before a claim can be approved. Medicare is a federal health insurance program...
Dr. Zac Cartun, MD
Doctor of Medicine
To get orthotics covered by Medicare, a patient must first understand Medicare’s policy with orthotics and how to obtain and submit a claim properly.
Dr. Zac Cartun, MD
Doctor of Medicine
To Get your orthotics covered by insurance be sure to choose your policy carefully, call your insurance company and take the necessary steps
Dr. Zac Cartun, MD
Doctor of MedicineMany insurance plans offer some degree of coverage for custom orthotics when deemed medically necessary—but how much, certain requirements, and limitations vary between providers. Custom orthotics are sometimes classified as "Durable Medical Equipment" (DME) by insurance companies, however, coverage classification differs depending on the insurer. In some cases, they might be categorized as orthotics, prosthetics, or even podiatry services. It is important to review your policy requirements carefully to determine the correct classification, what percentage is covered, and whether prior authorization or a doctor's prescription is required. Some plans may require a letter of medical necessity from a podiatrist before approving a claim for orthotics.