Does Medicare Cover Foot Care For Diabetes
Yes, Medicare provides extra foot-related coverage for diabetics. Thats because they may develop neuropathy, which is nerve damage in the feet and legs, or peripheral artery disease, which reduces blood flow to the feet.
These problems increase the risk of ulcers and infections that may eventually lead to amputation. If you have diabetes-related lower leg nerve damage that can increase the risk of limb loss, Medicare covers foot exams every six months.
But the coverage is conditional. Medicare will pay for that exam only if you haven’t seen a foot care professional for another reason between visits.
Shoes and inserts. Because diabetic nerve damage can also cause changes in the shape of your feet and toes, Medicare will cover one pair of therapeutic shoes and the accompanying orthotic inserts each calendar year for people with severe diabetic foot disease.
While a podiatrist or other doctor must prescribe the shoes and inserts, and you can purchase them directly from these sources, you can also purchase them from a medically licensed:
- Orthotist, who makes and fits braces and splints for foot injuries or disorders.
- Pedorthist, who modifies and fits therapeutic footwear or orthotic support devices.
- Prosthetist, who makes artificial limbs for people with disabilities.
These medical professionals must be enrolled in Medicare, so its important to check with the provider before you make the purchases.
Keep in mind
How Do I Begin Getting Podiatry Services Through Medicare
Podiatry services may have other qualifications you need to meet first in order to get coverage and treatment through Medicare. To get a better understanding of Medicare and podiatry in your specific case, its always a good idea to talk with your doctor. A Medicare support specialist may also be able to help get your questions answered. Discussing the next steps with your chosen podiatrist can go a long way toward being clear on whats covered and what isnt when it comes to foot care services.
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Does Medicare Cover Toenail Fungus Treatment
The chances of getting a toenail fungus is higher in seniors. That is especially true with seniors who have chronic medical conditions or severe underlying conditions. This includes diabetes and immunodeficiency problems. There are a number of types of treatment for toenail fungus including laser treatment.
If you are looking to treat this medical issue, a common question you likely have is, does Medicare cover toenail fungus treatment? In this article, we answer that question in clear, plain English. You will also find the average costs of treatment for toenail fungus if you have to pay for it yourself.
Why Choose Arizona Foot Doctors For Nail Fungus Removal
At Arizona Foot Doctors of Scottsdale, we use the safe, effective PinPointe FootLaser for gentle, painless toenail laser treatment. Each appointment lasts about 30 minutes, and you can go right back to your regular activities with no downtime. After laser foot treatment, our podiatrists will recommend follow-up visits to assure that the nails are recovering and determine if additional treatments are necessary. When you schedule a consultation with our team, youll learn more about laser toenail fungus cost and what to expect during the procedure.
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Ways To Prevent Fungal Infections Of The Toenails
Fungal organisms do best in warm, moist environments, making covered shoes the perfect place for them to prosper. Keep your toenails trimmed short and your feet as dry as possible, and consider the following tips:
- After bathing or showering, dry the feet thoroughly, especially the spaces between the toes. It also pays to use a hairdryer for optimal dryness.
- When in places like public pools, beaches, or locker rooms, always wear sandles. This is one of the best ways to avoid picking up a fungal infection.
- Stick to synthetic socks, not cotton. These wick sweat away instead of becoming soaked by it. Also, change your socks once during the day.
- Wear breathable shoes that fit properly.
- Wear breathable socks. Avoid tight stockings which compress the toes and can trap moisture between them.
- Dont pick at the skin surrounding your nails.
- Use an antifungal spray or powder daily, both on your feet and in your shoes.
- If you do your own pedicures, keep your equipment disinfectedand insist that your nail salon does the same. Trust your gut when choosing a salon.
- Covering up with nail polish wont work. It might make things look better temporarily, but will ultimately make the problem worse, as it seals in moisture, providing an even better environment for fungus to multiply.
What Is Nail Fungus Treatment
According to the Mayo Clinic, nail fungus can be difficult to treat and even after successful treatment nail fungus often comes back.
You may start with over-the-counter nail cream or ointment. If that doesnt work, there are several prescription medications available including oral antifungal drugs, medicated nail polish, and medicated nail cream.
In some cases, your doctor may recommend surgery as nail fungus treatment. Surgery could temporarily remove the nail so antifungal medication can be applied directly under the nail. Surgery also might involve permanent nail removal if the infection is severe.
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Does Medicare Pay For Podiatrist To Cut Toenails
Generally, podiatry services are not covered by Medicare. Podiatry is also eligible for a rebate under the ancillary or extras table of most private health insurers.
How Much Does Medicare pay for toenail cutting?
You pay 100% for routine foot care, in most cases. Routine foot care includes: Cutting or removing corns and calluses. Trimming, cutting, or clipping nails.
Does Medicare Cover Nail Fungus Treatment
- Learn if Medicare covers nail fungus treatment procedures and the specific criteria that must be met for recipients to receive limited podiatry coverage.
Toenail fungus is an infection of the toenails that causes white or yellow spots to develop on the nail. The medical term for nail fungus is onychomycosis. In many cases, mild cases of toenail fungus can resolve on their own as the nail grows out or with home remedies. However, if the infection spreads deep into the nail, medical intervention may be required. Individuals with underlying health issues that compromise the immune system may be at especially high risk of the infection traveling to areas outside of the nail bed.
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How Do I Qualify For These Benefits And What Rules Apply
Your condition needs to be under treatment by a physician to qualify for coverage. Your healthcare provider will need to show documentation that youre receiving treatment for a condition that requires foot care. Youll need to be receiving active care for 6 months for that condition for Medicare to begin paying.
Make sure youre enrolled in either Medicare Part B or a Medicare Advantage plan. Medicare Part A only covers hospital and long-term care expenses. Your podiatrist or other foot care provider will need to be enrolled in Medicare and accept assignment. If youre using a Medicare Advantage plan, you might need to use a provider whos in your plans network.
Your costs will depend on whether you have original Medicare or a Medicare Advantage plan.
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Laser Treatment For Nail Fungus Did Not Prove Effective
Becker and Bershow reviewed the scientific studies of laser therapy for toenail fungus and found no effective results in randomized, controlled, clinical trials. In addition, the therapy was not painless and recurrence of fungal infection was high.
However, the authors of the literature review acknowledged that reinfection is so common with nail fungus that it is possible that reinfection, not recurrence of the original infection, was responsible for the unpersuasive results.
Another study, published in the Journal of the American Academy of Dermatology, noted that laser treatment did not produce a cure when tested on humans with toenail fungus. The researchers noted that only one kind of laser light was tested. Nevertheless, they stated about their results: In vivo treatment did not result in onychomycosis cure meaning that the testing of laser treatment on human patients did not produce a toenail fungus cure.
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How Long Does The Procedure Take
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The amount of time varies on the degree of involvement of the nails. Very thick nails are mechanically reduced to a more normal thickness with specialized equipment. The laser is then applied typically taking only a few minutes. Overall, a visit for consultation and treatment will usually take about 30 minutes.
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How Do You Know If You Have Toenail Fungus
Your best bet is to get your toenails looked at by your trusty podiatrist. If you see any of the signs weve mentioned, just make an appointment for an evaluation. Since the infection will usually spread, youre better safe than sorry.
Detecting it early also improves the chances for the treatment to do its thing and keep it from moving onto other nails or your skin.
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How Often Should I Bring My Senior Parent For Nail Trims And Foot Care
As your loved ones age, the skin on their feet loses elasticity and thickness, causing them to be more prone to blisters and foot infections. Foot infections are particularly dangerous for those with diabetes or a weakened immune system.
Cutting their own toenails can become difficult or impossible for older folks due to aches and pains that prevent them from being as flexible as they once were. For some, weakened eyesight can make seeing their toenails harder than it used to be.
At All Care Foot & Ankle Center, Dr. Michael Tran understands that your older lover one may need help with their foot care, as physical issues may prevent them from getting the job done on their own. In addition, people with diabetes may need regular appointments to check for small cuts and sores that can become infected.
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Does Medicare Advantage Cover Podiatry
Some people decide to sign up for Medicare Advantage plans instead of getting their benefits directly through the government. Since Medicare Advantage delivers your Medicare Part A and Part B coverage through a private, Medicare-approved insurance company, you can expect that your foot care coverage is at least the same as described above. Some Medicare Advantage plans include additional benefits.
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Medicare Coverage For Toenail Clipping
by Patricia Barry, AARP Bulletin, September 22, 2008
Q. I go to a podiatrist to have my toenails clipped. As Im diabetic, shouldnt Medicare cover the cost?
A. Maybe, but it depends on the circumstances. Medicare doesnt normally cover nail clipping or any kind of routine foot care. Youre correct that diabetes mellitus is one of the medical conditions that may justify coverage but only if:
- A doctor has been treating you for diabetes in the six months before the nail clipping, and
- You have a complication of diabetes that is limiting your ability to walk or affecting your feet adversely , or
- You have a condition related to your diabetes affecting your feet that would make it unsafe for anyone except a podiatrist or other health professional to clip your nails.
These coverage rules also apply to foot problems that result from other medical conditions besides diabetes, including cancer, multiple sclerosis, chronic kidney disease, malnutrition and inflammation of the veins related to blood clots.
The bottom line: To get Medicare coverage for foot care, you need your doctor or podiatrist to provide evidence as to why it is medically necessary.
Patricia Barry is a senior editor at the AARP Bulletin.
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C And Part D Coverage For Toenail Fungus Treatment
Medicare Advantage plans also provide coverage for treatment for toenail fungus. These plans have to provide coverage for everything Original Medicare does. However, theyll also provide coverage from some things that Original Medicare does not cover. Exactly what a Part C plan covers and how much the out-of-pocket costs are will vary depending on the specifics of your plan.
Medicare Part C plans that include prescription drug plans will also provide coverage for medications that your healthcare provider will prescribe to you to treat your toenail fungus.
Aside from treatments like laser treatment and nail debridement, another way of treating toenail fungus is through prescription medication. Medicare Part D plans provide coverage for toenail fungus medications. Medicare Part D is a prescription drug plan, and just like Medicare Part C, Medicare Part D plans are provided by private insurance companies.
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My Nails Have Become Discolored And Are Thickening What Can I Do To Prevent Them From Getting Worse
The main reason nails become discolored and thick is nail fungus. Nail fungus thrives in warm, dark, and moist environments, which describes the inside of a shoe. Keeping the feet cool, dry, and open to air and light is the way to prevent nail fungus from proliferating. Wearing moisture-wicking or wool socks will prevent moisture build-up in your feet. Cotton, though it is a natural fabric, is not recommended as it holds moisture close to your skin, especially in the enclosed environment your shoe creates. If you work out, removing your shoes and wearing open-toed shoes immediately after your workout will also reduce moisture build-up. There are over-the-counter products which you can use to combat athlete’s foot and disinfect your shoes as well as ultraviolet shoe trees which kill fungus in your shoes. The bottom line with respect to foot hygiene for athlete’s foot and nail fungus is to keep the feet as cool and dry as possible.
Once fungus infects under your nails it becomes much more difficult to treat. There are two effective treatments on the market today, oral anti-fungal medication and laser therapy. Most patients opt to treat with the laser, as it does not pose the same risks that oral medications present to the liver. Topical treatments, though much improved, are still not effective enough to be used as a primary treatment. For more information on how to treat your specific case of athletes foot and nail fungus, please make an appointment for an evaluation.
Does Medicare Cover Care For Ingrown Toenails
Under normal circumstances, toenails grow out straight over the flesh. An ingrown toenail occurs when a nail, usually on the big toe, grows into the skin. There are several possible reasons this can happen, ranging from injury to ill-fitting shoes to inadequate grooming habits. Sometimes, it is simply a matter of heredity. When toenails mine into soft tissue, it is a painful experience that leads to swelling and reddish irritation.
Medicare Benefits to Treat Disorders of the FeetMedicare Part B covers podiatrist examinations and treatment of feet for people diagnosed with diabetes-related nerve damage. The patient is responsible for the 20% coinsurance plus the deductible. There may also be a co-payment due to the hospital if care is provided in a hospital outpatient center. In an overview of diabetic neuropathy, the Mayo Clinic explains that high blood sugar can cause damage to nerves throughout the body and frequently injures the nerves in the feet as well as the legs. Diabetics need to be particularly attentive to foot care and impede such issues as ingrown toenails.
For ingrown toenails, a podiatrist may remove a section of the nail and give you a prescription to treat the infection. However, in the case of a chronic condition, a more aggressive action may be necessary such as a chemical or laser procedure that removes the corner of the iniquitous nail and its matrix.
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