Foot Care for Seniors: What Medicare Covers and Why It Matters

Foot problems increase sharply with age — by 65, most people have some degree of foot pain, deformity, or functional limitation. The good news is that Medicare covers more podiatric care than most seniors realize. The frustrating part is that the coverage rules aren't always straightforward, and many eligible patients miss out on care they're entitled to simply because they don't know it's covered.

What Medicare Part B Covers

Treatment of medical conditions. Any podiatric treatment for a diagnosed medical condition is generally covered under Medicare Part B. This includes treatment for bunions, hammertoes, heel pain, plantar fasciitis, arthritis, bone spurs, neuromas, tendinitis, fractures, sprains, infections, and other foot and ankle pathology. You pay the standard 20% coinsurance after your Part B deductible is met.

Diabetic foot care. Medicare provides specific benefits for patients with diabetes. A comprehensive foot exam is covered annually to check for peripheral neuropathy and circulation problems. Therapeutic shoes and custom inserts are covered for diabetic patients with qualifying conditions — one pair of custom molded shoes or one pair of depth shoes with three pairs of inserts per calendar year. Routine foot care (nail trimming, callus debridement) that would normally be excluded becomes a covered service for diabetic patients because the risks of self-care are medically significant.

Nail and callus care for qualifying conditions. This is the area that confuses most people. Medicare does not cover "routine" nail trimming and callus removal for otherwise healthy patients. However, if you have a systemic condition that creates risk — diabetes, peripheral neuropathy, peripheral vascular disease, or you take anticoagulant medications — the same nail and callus care becomes medically necessary and is covered. The difference isn't the service itself but the medical context.

Surgery. Medically necessary foot surgery is covered, including minimally invasive procedures for bunions, hammertoes, bone spurs, neuromas, and other conditions. Surgical coverage includes the procedure, anesthesia, post-operative visits, and any necessary imaging.

What Medicare Doesn't Cover

Medicare explicitly excludes "routine foot care" for patients without qualifying conditions. This means if you're generally healthy without diabetes, neuropathy, or vascular disease, Medicare won't cover regular toenail trimming, callus removal, or corn treatment. These are considered personal hygiene rather than medical services.

Flat feet treatment is covered only if it causes significant pain or functional limitation. Supportive shoes and over-the-counter insoles are not covered (except therapeutic shoes for diabetic patients). And cosmetic procedures are excluded.

Why Regular Foot Care Matters More as You Age

The feet undergo predictable age-related changes. Fat pad atrophy (thinning of the cushioning under the heel and ball of the foot) makes walking on hard surfaces increasingly uncomfortable. Skin becomes thinner and drier, more prone to cracking and infection. Nails thicken and become harder to trim. Joint flexibility decreases, contributing to stiffness and altered gait. Circulation declines, slowing wound healing. And the cumulative effect of decades of weight-bearing takes its toll on joints, tendons, and ligaments.

These changes mean that minor foot problems that would be insignificant in a younger person — a thick toenail, a callus, a small skin break — can become gateways to more serious complications in seniors. An ingrown toenail that a 30-year-old ignores for a week might heal on its own. The same ingrown nail in a 75-year-old with diabetes and poor circulation can become a limb-threatening infection within days.

Common Foot Problems in Seniors

The conditions we see most frequently in senior patients include thickened and fungal toenails (often too difficult to trim safely at home), painful calluses and corns from altered foot mechanics, ingrown toenails — especially dangerous in patients with diabetes or blood thinners, bunions and hammertoes that have progressed to the point of causing daily pain, balance and stability issues related to foot pain or deformity, peripheral neuropathy with loss of protective sensation, and skin breakdown or non-healing wounds.

Making the Most of Your Medicare Foot Care Benefit

If you have diabetes, peripheral neuropathy, or vascular disease, you qualify for covered foot care that can prevent serious complications. Schedule your annual comprehensive foot exam. Don't attempt nail care at home if you have reduced sensation, poor circulation, or take blood thinners — this is exactly what the Medicare benefit is designed for.

If you're unsure whether your foot care is covered, our office verifies your specific Medicare benefits before your appointment. We want you to know exactly what to expect financially so cost isn't a barrier to getting care that may be more important than you realize.