Diabetic Therapeutic Shoes: Medicare Coverage, Brands & Fit

Diabetic therapeutic shoes are medical-grade footwear designed to protect sensitive feet and reduce the risk of sores, ulcers, and amputations in people living with diabetes. They use extra depth and width, smooth interiors, and cushioned, removable inserts to spread pressure and prevent friction and rubbing. Unlike regular shoes, they’re made to accommodate deformities, swelling, and custom inserts. When your doctor certifies medical need, Medicare often helps pay for them each year.

In this guide, you’ll learn exactly who benefits from therapeutic shoes, how they work, and the features to look for. We’ll compare extra-depth and custom‑molded options, outline Medicare coverage and documentation, and walk you step‑by‑step through getting a pair—fitting included. You’ll also find brand suggestions, cost scenarios, sizing tips, and care advice so you can choose confidently and get the most protection from every step. Everything is based on current U.S. Medicare rules.

Who needs diabetic therapeutic shoes

People with diabetes benefit most from diabetic therapeutic shoes when their feet are at higher risk for friction, pressure, and wounds. If you have nerve damage or numbness, deformities, calluses, or circulation problems, these medical shoes help prevent sores and infections by reducing pressure points and irritation. Medicare typically approves coverage when your diabetes is complicated by foot risk factors—your treating doctor must certify medical need, and a podiatrist or other qualified doctor must prescribe them.

• Peripheral neuropathy or numbness: Reduced sensation hides rubbing and blisters.
• History of foot ulcers or hard-to-heal sores: Requires targeted pressure offloading.
• Pre‑ulcerative calluses or thickened skin: Signals high-pressure areas that need protection.
• Foot deformities (bunions, hammertoes) or swelling: Need extra depth/width and seamless interiors.
• Poor circulation: Increases risk of skin breakdown and infection.
• Need for inserts: Shoes that accept cushioned, removable or custom inserts for pressure relief.

How therapeutic shoes protect your feet

Diabetic therapeutic shoes work as a system—shoe plus insert—to spread pressure, limit friction, and shield vulnerable skin. Extra depth and width create space for toes and deformities, while seamless, soft linings reduce rubbing. Removable, cushioned inserts absorb shock and can be custom-shaped to offload hotspots so ulcers are less likely. Stretchable uppers accommodate swelling during the day, and supportive structures help keep the foot from sliding and shearing inside the shoe.

• Pressure redistribution: Cushioned and custom inserts take load off bunions, hammertoes, calluses, and previous ulcer sites.
• Friction control: Seamless, soft interiors and multi‑density padding minimize rubbing and shear.
• Room to accommodate: Extra‑depth designs, wider sizes, and stretch materials reduce crowding and irritation.
• Supportive stability: Arch support and a secure heel counter help limit foot motion that can cause hotspots.

Features to look for in diabetic shoes and inserts

The right diabetic therapeutic shoes should lower friction, spread pressure, and leave room for deformities and swelling—while holding inserts securely. Focus on fit and interior feel first, then on insert compatibility. If you plan to use Medicare, choose shoes and inserts that meet medical-grade standards and coding.

• Seamless, soft interiors: Reduce rubbing and irritation that can trigger sores.
• Stretchable uppers: Gently adapt to swelling and prominent toes without pressure points.
• Extra depth and multiple widths: Create space for deformities and custom inserts.
• Removable, cushioned inserts: Allow shock absorption and easy replacement when worn.
• Arch support and stable heel counter: Improve alignment and limit foot motion that causes hotspots.
• Adjustable closures (laces/straps): Enable a secure, non-binding fit throughout the day.
• Protective, smooth toe area: Prevents seams or hard overlays from contacting sensitive skin.
• Custom or heat-moldable inserts for offloading: Target pressure relief where you’re prone to calluses or ulcers.
• Medicare-ready coding for inserts (A5500): Signals eligibility for reimbursement when criteria are met.

A shoe–insert system that combines these features offers the best day‑to‑day protection for diabetic feet.

Types of diabetic footwear and inserts (extra-depth vs custom-molded)

Diabetic therapeutic footwear falls into two buckets: extra-depth shoes that accommodate protective inserts, and custom-molded shoes built from a cast or scan when standard options can’t fit safely. Both are paired with removable inserts—prefabricated or custom—to redistribute pressure, protect previous ulcer sites, and minimize friction on sensitive skin.

• Extra-depth shoes (A5500-coded): Off-the-shelf medical shoes with added depth, multiple widths, and smooth, stretchable interiors. Ideal for neuropathy, swelling, and mild-to-moderate deformities; versatile for daily wear and compatible with cushioned inserts.
• Custom-molded shoes: Fabricated from your foot mold/scan to match unique contours. Chosen for significant deformity, partial foot amputation, or when extra-depth shoes still cause irritation or poor fit.
• Prefabricated inserts: Multi-density, often heat-moldable, to absorb shock and offload common hotspots; replaced regularly as cushioning compresses.
• Custom inserts: Made from impressions to precisely offload bony prominences or prior ulcer locations; used when targeted pressure relief is critical.

Medicare coverage at a glance (what’s covered and how often)

Medicare Part B helps pay for diabetic therapeutic shoes and inserts each calendar year when your diabetes‑treating doctor certifies medical need and a podiatrist or other qualified doctor prescribes them. After the Part B deductible, you typically pay 20% of the Medicare‑approved amount. You must use a Medicare‑enrolled supplier for coverage to apply.

• Choose one shoe type per year: One pair of extra‑depth shoes or one pair of custom‑molded shoes (customs include inserts).
• Annual inserts allowance: Up to 3 pairs of inserts with extra‑depth shoes, or 2 additional pairs with custom‑molded shoes.
• Modifications instead of inserts: In some cases, covered shoe modifications can be provided in place of inserts.
• Medicare-ready products: Items billed under approved diabetic/therapeutic codes (for example, A5500 inserts) are eligible when criteria are met.

Medicare eligibility and documentation requirements

To qualify under Medicare Part B, you must have diabetes, your diabetes‑treating doctor must certify medical need, and a podiatrist (foot doctor) or other qualified doctor must prescribe the diabetic therapeutic shoes and inserts. Items must be provided by a Medicare‑enrolled supplier, and the medical record must clearly support why therapeutic footwear is necessary for prevention of ulcers and related complications.

• Physician certification: Your doctor who manages your diabetes certifies you have diabetes and need therapeutic footwear.
• Qualifying foot risk(s): Documentation of at least one covered risk such as previous amputation, prior ulceration, pre‑ulcerative calluses, peripheral neuropathy with callus, foot deformity, or poor circulation.
• Prescription (detailed order): Specifies shoe type (extra‑depth or custom‑molded), size/width, and the number/type of inserts or modifications.
• Supporting clinical notes: Chart entries that describe symptoms, exam findings (e.g., neuropathy, deformities), and goals (pressure offloading, friction reduction).
• Medicare‑enrolled supplier and correct coding: Shoes/inserts billed under approved therapeutic shoe codes (for example, A5500‑coded inserts) through a participating supplier.
• Timely, complete paperwork: Missing or incomplete records commonly lead to claim denials, so coordination between your doctors and supplier is essential.

Step-by-step: how to get Medicare-covered shoes

Securing Medicare-covered diabetic therapeutic shoes is smooth when you line up the right clinicians and paperwork. Your diabetes-treating doctor certifies medical need, a podiatrist or other qualified doctor writes the prescription, and a Medicare-enrolled supplier fits and dispenses the shoes and inserts. Follow this sequence to avoid delays or denials.

1. Start with your diabetes doctor: Schedule a visit to document diabetes and at least one qualifying foot risk (e.g., neuropathy, prior ulcer, pre‑ulcerative calluses, deformity, or poor circulation) and obtain a signed medical-necessity certification.
2. Get a prescription: See a podiatrist (or other qualified prescriber) for a detailed order specifying shoe type (extra‑depth or custom‑molded), size/width, and the number/type of inserts or modifications.
3. Choose a Medicare-enrolled supplier: Bring the certification, prescription, and relevant clinical notes; confirm your Part B benefits, deductible status, and expected coinsurance.
4. Be professionally fitted: Receive weight‑bearing measurements, evaluate widths and depths, and try on styles to ensure toe room, stable heel hold, and a smooth, irritation‑free interior.
5. Select inserts: Use cushioned, Medicare-coded inserts (e.g., A5500) or have custom inserts made if targeted offloading is needed.
6. Confirm coverage and costs: The supplier verifies coding and submits the claim; you’re responsible for the Part B deductible (if not met) and typically 20% coinsurance.
7. Pick up and check fit: Review break‑in instructions and daily skin checks; arrange a follow‑up to adjust fit or offloading if any hotspots appear.
8. Plan annual renewal: Keep copies of your documents and repeat certification/prescription when you’re eligible for next year’s shoes and inserts.

Missing or incomplete paperwork is a common reason for denials—coordinate among your doctors and supplier before dispensing.

Where to buy and get fitted (podiatry clinics and PDAC-approved suppliers)

The safest path to a great fit is an in-person fitting at a podiatry clinic or a Medicare-enrolled DME supplier that dispenses PDAC-verified diabetic therapeutic shoes and inserts. Many clinics—including full-service podiatry practices—can evaluate your risk, write the prescription, and coordinate with an approved supplier so your paperwork, sizing, and claim are handled correctly.

• Choose a Medicare-enrolled supplier: Confirm they bill Part B for therapeutic footwear.
• Ask for PDAC-verified products: Especially A-codes for inserts (e.g., A5500).
• Insist on professional measurement: Length, width, depth, and weight‑bearing checks.
• Verify follow-up support: Adjustments, insert replacement, and exchange policies.
• Bring documentation: Certification, prescription, and recent clinical notes to avoid delays.

Costs, copays, and insurance scenarios

Under Medicare Part B, eligible diabetic therapeutic shoes and inserts are covered each calendar year when ordered and supplied correctly. After you meet the Part B deductible, you typically pay 20% of the Medicare‑approved amount through a Medicare‑enrolled supplier. If you exceed the annual allowance (for example, need more inserts than covered) or choose non‑covered options, you’ll pay the difference out of pocket.

• Original Medicare (Part B): Deductible (if not yet met) + 20% coinsurance on the approved amount for covered shoes/inserts furnished by an enrolled supplier.
• Medigap (Medicare Supplement): May reduce or cover your Part B coinsurance; confirm with your plan.
• Medicare Advantage (Part C): Copays, authorizations, and supplier networks can differ; verify plan rules and use in‑network, Medicare‑approved suppliers.
• Not meeting criteria/missing documentation: Claims are commonly denied; you would be responsible for the full cost.
• Using a non‑enrolled supplier: Medicare won’t pay; you could owe the entire amount.
• Extra items beyond allowance: Additional inserts or an extra pair of shoes in the same year are typically out‑of‑pocket.
• Modifications vs inserts: Certain modifications may be covered in place of inserts; anything beyond the covered configuration is patient pay.

Ask the supplier to verify benefits, codes (e.g., A5500 for inserts), and your expected responsibility before dispensing to avoid surprises.

Approved brands and styles to consider

If you’re comparing Medicare-covered diabetic therapeutic shoes, prioritize manufacturers that build medical-grade, PDAC-verified footwear and A5500-coded inserts. Styles range from athletic to dress and boots—pick based on your daily activity, swelling pattern, and need for stretch vs. structure. Always confirm specific model verification and coding with your Medicare-enrolled supplier.

• Dr. Comfort: Athletic, casual, and dress options with seamless interiors, cushioned insoles, and arch support; multiple widths for extra depth.
• Apex: Walking and running styles focused on comfort and protective fit with roomy toe boxes and supportive platforms.
• Anodyne: Lightweight designs using soft, protective materials; stretch uppers and smooth linings to limit friction.
• Orthofeet: Seamless, stretchable linings with extra-depth designs; good for hammertoes, bunions, and mild swelling.
• SAS (select styles): Some models qualify for diabetic/Medicare use—verify PDAC status and coding per style.
• Silverts (slippers/walking): Extra width and adjustable closures for sensitive or swollen feet; confirm coverage eligibility.

Tip: Match shoes with PDAC-verified, A5500-coded inserts (prefab or custom) to meet coverage and offloading goals.

Getting the right fit: measurements, widths, and break-in

A protective fit starts with precise, weight‑bearing measurements. Have both feet measured while standing, and fit the larger foot. Depth matters as much as length—diabetic therapeutic shoes should create space for toes, calluses, and deformities without pressure, and securely hold your inserts so they sit flat and don’t buckle. Try shoes late in the day to account for swelling, and wear the socks you plan to use daily.

• Length and toe room: Fit to your longest toe and ensure clear space in front without crowding.
• Widths and depth: Choose from multiple widths; the right pair reduces pinch at the forefoot yet keeps the heel comfortably secure.
• Lock-in without pressure: A firm heel counter and adjustable closure should hold the foot without rubbing.
• Interior check: Feel for smooth, seamless linings; no hot spots at bunions, hammertoes, or previous ulcer sites.
• Insert compatibility: Inserts must seat fully and stay stable inside the shoe.

Break in gradually. Start with short, indoor wear, checking your skin after each session. Any redness that doesn’t fade or new rubbing means you should stop and have the fit or inserts adjusted before resuming.

What to expect at your fitting appointment

Your visit starts with a quick paperwork check—physician certification, prescription, and benefit verification—followed by a weight‑bearing measurement of both feet. The clinician examines skin, deformities, and gait, then has you try multiple widths and depths to confirm toe clearance, heel security, and a smooth, irritation‑free interior. Inserts are selected and heat‑molded if prefabricated, or impressions are taken if custom is required. You’ll leave with break‑in and daily skin‑check instructions, and a plan for follow‑up adjustments.

• Precise measurements: Length, width, and depth while standing; fit the larger foot.
• Try‑ons and adjustments: Check toe room, heel hold, and interior seams.
• Insert selection: A5500‑coded prefab (often heat‑molded) or custom impressions.
• Coverage confirmation: Supplier submits the claim; you review any coinsurance.
• Education and follow‑up: Break‑in schedule, skin checks, and an adjustment visit if needed.

Care, maintenance, and when to replace shoes and inserts

Simple habits keep diabetic therapeutic shoes protective and comfortable. After wearing them, air‑dry the shoes, remove inserts so moisture escapes, and check your skin for any redness. Clean gently, avoid heat, and watch for wear that creates new pressure points. Consistent care extends life—and preserves the offloading you depend on.

• Clean and dry: Wipe with a damp cloth and mild soap; air‑dry away from heaters or sunlight. Never use a washer/dryer.
• Remove inserts nightly: Let inserts and interiors dry fully; wear clean, moisture‑wicking socks each day.
• Inspect daily: Feel inside for seams, wrinkles, or grit; check inserts for flattening, cracking, or curled edges.
• Protect shape: Use a shoehorn, don’t overtighten closures, and keep debris out of the toe box.
• Replace when needed: Shoes with uneven tread, leaning, or interior ridges—and inserts that are compressed, creased, or cause new hotspots—should be replaced. Coordinate timing with your annual Medicare allowance to minimize out‑of‑pocket costs.

Beyond shoes: ongoing diabetic foot care and prevention

Your diabetic therapeutic shoes work best alongside a simple, daily foot-care routine and regular medical follow‑up. Control blood sugar, quit smoking, and manage blood pressure and cholesterol to improve healing and circulation. Schedule risk‑based podiatry visits for callus care, nail management, and early treatment of any hot spots before they become ulcers.

• Daily checks: Inspect tops, soles, and between toes; report new redness, warmth, blisters, drainage, or skin breaks.
• Socks & hygiene: Wear clean, moisture‑wicking socks; dry well; moisturize heels/soles (not between toes).
• Nails & skin: Trim nails straight across; don’t self‑treat corns/calluses—see your podiatrist.
• Call promptly: Pain, swelling, color change, or any wound needs same‑day evaluation.

Frequently asked questions

Here are quick answers to common questions about diabetic therapeutic shoes, Medicare coverage, and getting the right fit. Use them to confirm eligibility and avoid denials, then review specifics with your podiatrist and a Medicare‑enrolled supplier. Details here refer to Medicare Part B; Medicare Advantage plans may have different rules.

• Do I need a prescription? Yes. Your diabetes‑treating doctor must certify medical need, and a podiatrist or other qualified doctor must prescribe the shoes and inserts.
• How often are they covered? Generally one pair of extra‑depth or custom‑molded shoes per calendar year, plus inserts (up to 3 pairs with extra‑depth, or 2 additional pairs with custom shoes).
• Who can supply them? A Medicare‑enrolled supplier. Using a non‑enrolled supplier typically means no Medicare payment.
• What codes matter for inserts? Look for Medicare‑ready, PDAC‑verified inserts (commonly billed under A5500) to support coverage.
• Are certain brands “approved”? Specific models—not just brands—must be verified. Common medical brands include Dr. Comfort, Apex, Anodyne, and Orthofeet; some SAS styles may qualify—confirm PDAC status per model.
• Can I buy online? Only if the seller is Medicare‑enrolled and handles the required documentation; an in‑person fitting is the safest way to ensure protection and prevent hotspots.

Key takeaways

Diabetic therapeutic shoes reduce pressure, friction, and ulcer risk when paired with the right inserts and an expert fit. Medicare Part B often helps every calendar year—if your diabetes-treating doctor certifies medical need and a podiatrist (or other qualified prescriber) writes the order. The fastest path to approval is complete documentation, a Medicare-enrolled supplier, and PDAC-verified products.

• Coverage: One pair/year (extra-depth or custom) plus an annual inserts allowance.
• Eligibility: Diabetes + qualifying foot risk; physician certification and prescription required.
• Supplier/coding: Use Medicare-enrolled suppliers; PDAC-verified, A5500-coded inserts support claims.
• Fit: Weight-bearing measurements, multiple widths/depths; gradual break-in and daily skin checks.
• Costs: After Part B deductible, expect 20% coinsurance; Medigap/Advantage rules vary.

Ready to get protected and covered? Schedule a fitting at Achilles Foot and Ankle Center.