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Benjiman Hewlett, Certified Orthotist

Q. Is it true that Medicare will pay for shoes?

A. Medicare covers diabetic shoes, inserts and modifications for program beneficiaries only if the following criteria are met:

(a) The patient has diabetes and one or more of the following conditions:

• Previous amputation of the other foot, or part of either foot, or
• History of previous foot ulceration of either foot, or
• History of pre-ulcerative calluses of either foot, or
• Peripheral neuropathy with evidence of callus formation of either foot, or
• Foot deformity of either foot, or
• Poor circulation in either foot; and

(b) The certifying physician who is managing the patient's systemic diabetes condition has certified that (1) one or more of the indications required by (a) above are present, (2) he or she is treating the patient under a comprehensive plan of care for his or her diabetes, and (3) the patient needs diabetic shoes, inserts or modifications.

Q. What is Covered?

A. For Medicare beneficiaries meeting criteria described above and with the proper documentation, coverage is limited to one of the following within 1 calendar year:

• 1 pair of off-the-shelf depth shoes and 3 additional pairs of molded multi-density inserts.
• 1 pair of off-the-shelf depth shoes including a modification, and 2 additional pairs of molded multi-density inserts.
• 1 pair of custom-molded shoes and 2 additional pair of molded multi-density inserts.

The footwear must be fitted and furnished by a podiatrist or other qualified individual, such as a pedorthist, orthotist, or prosthetist.

Q. If I choose to have breast reconstruction after my mastectomy, do I still need to be fit with a breast prosthesis?

A. Even if you are considering reconstruction at some later time, it is important to wear a weighted form during the intervening time, the form will replace weight to restore the body’s natural balance relieving the spine from compensating the difference.

Q. I just had a mastectomy and I want my clothes to fit, but I am not ready for a weighted prosthesis, is there something I can wear in the meantime?

A. Yes, it is called a post op camisole there are many styles available and it is just a very soft camisole with pockets at the breast, they come with a very lightweight shaped breast that slips in the pockets to give you projection without the added weight they also have smaller pockets to hold drainage tubes. Medicare and most insurances will cover a post op camisole and a weight breast prosthesis and bras.

Q. How often will Medicare allow me to get bras and prostheses?

A. Medicare will allow you to get a silicone breast prosthesis and bras as per medical necessity, a breast prosthesis maybe replaced every two years and sooner if there is a change in medical necessity, for example a weight change that requires a different size and a new prescription would be required. There is no set limit on bras just as per medical necessity, but I have found that up to six bras per calendar year have been covered.