Q. I go to a podiatrist to have my toenails clipped. As I’m diabetic, shouldn’t Medicare cover the cost?
A. Maybe, but it depends on the circumstances. Medicare doesn’t normally cover nail clipping or any kind of routine foot care. You’re 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;
* You have a complication of diabetes that is either limiting your ability to walk or is affecting your feet adversely—for example, loss of sensation, muscle pain, swellings, ulcers, mycosis (fungal infection) of the toenails, etc.; 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.
A visit to a podiatrist is a benefit covered by most insurance plans. However, there can be restrictions due to changes in recent health care coverages.
To avoid any additional cost to the patient, Podiatry Group of Georgia will work with your insurance company to get your services covered. Sometimes this requires our office to send in a letter of medical necessity which will state the reasoning behind the recommended treatment and include the patient’s history and diagnosis.
As a courtesy to our patients, we will contact your insurance company prior to your visit to verify that services are covered and that no referrals are required. This allows us to provide you with the best care while making sure you are aware of your insurance benefits for any treatments or services recommended for your specific condition before they are performed.
If you are having any foot pain, or overall concerns with your feet and want to schedule an appointment, please contact our office at (404) 806-3731. We will be able to help to you with any of your insurance concerns. Your insurance company will also be able to review your plan with you prior to your visit.
If you’ve been searching for Foot Doctor for all your foot and ankle needs, take time to meet with the Podiatry Group of Georgia. Our doctor has the experience and knowledge you need to help your feet and ankles feel their best. Give us a call today and set up an appointment for your initial consultation. Call us today
Call Our Marietta, Georgia Office Today at 404-806-3731 or Book your appointment online now!
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