Diabetic Shoes Program
Here is what you need from your physician(s):
1. Doctors Prescription
Physician’s prescription for diabetic shoes and/or inserts delivered by patient, fax, or mail.
Click here for Prescription.
2. Patient’s Office Visit Notes
Have your physician who treats you for your diabetes, fax or mail us a copy of an office visit note that shows
your physician has managed your diabetes within the last 5 months.
3. Patient’s Supporting Documentation
Fax or mail us an office visit note within the last 5 months from either the physician that treats you for your diabetes or from another physician (such as a podiatrist, NP, PA, etc) that describes one or more of the qualifying conditions listed below:
- Foot deformity
- Current or previous foot ulceration
- Current or previous pre-ulcerative foot calluses
- Previous partial amputation of one or both feet or complete amputation of one foot
- Peripheral neuropathy with evidence of foot callus formation
- Poor circulation of the feet
4. Medical Necessity Form
After we receive the documentation above, we will contact your physician for the Medical Necessity Form.
When we receive the completed Medical Necessity Form, we will contact you for an appointment.
Phone number: 636-946-1652 Fax number: 636-940-7463.
Medicare Coverage of Shoes and Inserts:
Coverage is limited to one of the following per calendar year:
- One pair of off-the-shelf extra-depth shoes and three additional pairs of special inserts.
- One pair of off-the-shelf extra-depth shoes including a modification, and two additional pairs of inserts.
- One pair of custom-molded shoes and two additional pairs of special inserts.
Medicare will pay 80% of the allowed amount after your deductible has been met. The remaining 20% will depend upon your secondary insurance plan. Check with your secondary insurer for the amount they will cover.
If you have a Medicare Advantage plan, contact your insurer for your amount of responsibility.