Does Health Insurance Cover Podiatry?
As a field of medicine, podiatry deals with issues of the foot and ankle. From injuries to disease-related foot and ankle issues, podiatrists treat a range of problems.
Most health insurance plans cover podiatric treatments. However, terms and conditions are likely to vary, as do specific exclusions. It is imperative that you read your individual health insurance policy with care when checking for coverage.
While most podiatrists and their offices participate in private and public health insurance plans, they might not accept all health insurance companies. So make sure you ask before you go in for an appointment.
What does a podiatrist treat?
According to the Board of Podiatric Medicine, there are 15,000 podiatrists who are licensed to practice in all 50 states, the District of Columbia, and Puerto Rico.
They are deemed specialists, who undergo medical and surgical training to treat problems of the foot and ankle. These include sports injuries, disease-related complications, pediatric deformities, ankle and heel pains, and broken foot bones and anklebones, among a host of others.
They also deal with issues from arthritis, foot issues related to obesity, peripheral arterial disease, and heart problems. Some other areas that are dealt with include peripheral neuropathies involving the foot caused by alcoholism and drug use; carcinomas; traumatic injury; hereditary matters; leprosy or neurosyphilis; and malnutrition or malabsorptive diseases such as celiac disease.
Board-certified podiatric surgeons repair, reconstruct, and correct a range of procedures such as the removal of bone spurs and severe bunions, and foot stabilization in cases of badly broken feet. They also work with care teams that manage ongoing medical conditions such as diabetes mellitus, which might impact the lower extremities.
In specific cases, podiatric surgeons also treat warts and mycotic nails. The coverage depends on the individual medical insurance plan.
Podiatrists have specific specialties such as sports medicine, geriatrics, biomechanics, pediatrics, surgery, or primary care. Depending on their preference, their training and certifications vary.
What are some of the exclusions for podiatric care?
Every health insurance plan has some exclusion within each category. But these exclusions vary depending on the health insurance plan under which you are covered. So for specific details, you should talk to your health insurance company or the benefits adviser at your place of work.
For instance, under Medicare there are certain conditions that are not covered. These include treatment of flat feet and the cost of supportive devices such as orthopedic shoes. Additionally, routine foot care such as removal of corns and calluses; debriding and cutting of nails; and preventative maintenance care are not included.
However, if routine care is associated with specific circulatory problems or diminished sensation of the extremities, then they might be covered. Much like any other medical insurance questions, the answers vary depending on the health insurance company and your individual health insurance plan.
You should always have a detailed conversation with your health insurance provider. This will give you clarity and help you choose the right path to foot health.
Are foot orthotics covered by health insurance plans?
Foot and ankle pain can be debilitating for some people in ways that impact the very quality of their lives. In such cases, foot problems may be alleviated using shoes inserts called orthotics.
According to the Hospital for Special Surgery, custom-made orthotics are medical devices that are placed in shoes to correct walking patterns that cause pain. They are meant to provide support, prevent deformity of the foot, and relieve pressure. In other words, the intent is to reduce pain and imbalance by improving the biomechanical action of the foot and ankle.
Orthotics are also used to reduce pain in the knee, back, and hip. Acting as shock absorbers, these devices reduce pressure and improve alignment. These customized inserts are also used to treat Achilles tendon and heel pain. Patients suffering from flat feet or overly high arches also use them.
Unfortunately, orthotics are not universally covered by health insurance companies. So you need to ask your health insurance company about your coverage options. If they do cover you, find out what additional expenses you might incur. Since these inserts can be a lifetime requirement, the out-of-pocket costs will add up quickly.
If you are not covered, you will have to pay out-of-pockets costs for your orthotics. According to Podiatric Today, this can set you back $400-$600 dollars.
This high cost for what basically look like two pieces of plastic occurs because of the entire procedure that is undertaken for customization. Since high quality foot orthotics require detailed biomechanical exam and gait analyses, podiatrists include these processes in the final cost. Add to this the cost of making the required impressions and the actual casting of the individualized devices and it explains the high bill for the foot inserts.
You might be able to set up a payment plan with your podiatrist. Talk to them about the various payment options available to you.