SENIORS EDUCATION ON MEDICARE COVERAGE FOR PODIATRY SERVICES
We know we can treat everything from ingrown toenails to plantar fasciitis to complex fractures in the foot and ankle, and we also know that older adults are more prone to chronic foot disorders, especially if they have an underlying condition like diabetes. According to a research of diabetic elders (US National Library of Medicine), teaching patients about foot self-care increases regular foot care, although those who rely on formal or informal help to undertake foot care do so less frequently than those who do it on their own. We also know that Medicare does not cover many podiatrist services, so maintaining overall foot health and avoiding the need for podiatric Medicare is critical.
Medicare’s rules
Based on the patient’s diagnosis and recommended therapy, Medicare has specific coverage restrictions. Make sure your doctor is aware of the regulations and can assist you in developing a treatment plan based on them. This will shed light on why certain choices are selected. It also informs the patient on how to provide assistance not just to themselves but also to their loved ones, both now and in the future.
Except in cases where another health condition needs it certain class findings (such as diabetic neuropathy) are met, Medicare does not fund routine foot care. It might be beneficial to include this information in your initial patient examination. You can see why it could not be a covered service if you understand the conclusions from the class. If that’s the case, you’ll need to request an Advance Beneficiary Notice (ABN) for the non-covered service (MedicareSupplement.com). An ABN, also known as a waiver of liability, is a notification that a provider should send you before you receive a service if your provider has reason to believe Medicare would not pay for the service based on Medicare coverage criteria.
SENIORS EDUCATION ON MEDICARE COVERAGE FOR PODIATRY SERVICES
There are no shoes for you.
Supportive equipment, such as orthopedic shoes, are also not covered by Medicare unless they are included in the cost of a leg brace or the patient has diabetes. Even if the patient has diabetes, eligibility for this service is determined by a specific algorithm, which may or may not include every patient with that diagnosis. Many diabetic patients mistakenly believe they are entitled to “free shoes,” when in reality, treatment is far more involved. If “free” isn’t in the cards for you, OTC insoles and inserts are a great option to diabetic shoes because they’re a fraction of the price while still offering useful foot support.
Only those podiatry services that are deemed required to diagnose or treat a medical problem will be covered by Medicare (Caring.com). Treatment for conditions including hammertoes, heel spurs, and bunion deformities is covered by Medicare as an evaluation and management visit. Patients, on the other hand, must be aware of their evaluation and what to expect in terms of coverage. Patients should be informed that certain procedures, including as X-rays, may require referrals or authorizations under Medicare Advantage plans.
Patients with diabetes may be more obviously qualified for foot care services because they are at a higher risk of acquiring foot problems (AARP). It is critical, however, that they comprehend the significance of the podiatrist in their general health and well-being. Within six months of their podiatrist appointment, they should be seeing their diabetes doctor (primary physician or endocrinologist). It’s astounding that this isn’t standard practice for some diabetic individuals.
Educating patients on how Medicare covers podiatry services
Part B of Medicare applies to podiatrist services because they are typically performed in an outpatient setting. Part B of Medicare will cover 80% of approved medical expenses. Both the annual deductible and 20% of the bill are the patient’s responsibility. Many patients are unaware of their annual deductible and are surprised when they receive their bill. Physicians should, in theory, take the time to educate patients, whether through office postings or a brief talk with all patients and employees.
Medicare Part A will kick in if individuals need surgery to treat a foot issue and are admitted to the hospital as inpatients. A higher deductible is required, as is the 20% co-insurance. This deductible also covers the first 20 days of care at a skilled nursing facility (SNF) if the patient’s recovery is advised to be completed there. Only if the patient was admitted to the hospital for at least three days will Medicare reimburse the SNF stay (Podiatry Today).
SENIORS EDUCATION ON MEDICARE COVERAGE FOR PODIATRY SERVICES
When a patient applies for Medicare, he or she may inquire about the following: