We continue to have a lot of clients inquiring about orthopaedic footwear coverage. Aside from custom foot orthotic coverage, this benefit is a lot more difficult to access and in many cases there are significant restrictions that prevent extended medical plan users from accessing their coverage. Here are five things to consider when claiming for orthopaedic shoes through your extended insurance plan.
- Check your Coverage: Prior to spending time shopping for orthopaedic footwear consider checking your insurance coverage. Many plans (i.e. Blue Cross) only cover custom made shoes, but not ready-made footwear (purchased off the shelf). If your policy wording isn't clear, call your insurance company to confirm whether you would be eligible to claim orthopaedic shoes bought off the shelf.
- Prescription: Your insurance will require a prescription (Rx) from your family doctor or podiatrist in order for you to submit your claim to your insurance. The prescription should include a detailed diagnosis that describes why you require this type of footwear.
- Fitting: Once you have a prescription available, book an appointment for a shoe fitting, so that we can help you find the appropriate footwear to assist you in relieving your foot, ankle, knee or hip condition.
- Estimate: Consider submitting an estimate with your prescription to your insurance company for a pre-approval, as we do not accept responsibility for denied claims.
- Brands & Footwear Features: Certain insurance companies only cover select brands. However, they will usually not make the list of approved brands available to you. Keep in mind that an orthopaedic shoe should have the following features: Strong heel counter, adjustable uppers, solid shank to provide ample arch structure and support, multiple width options (usually 3 or more), a large size range, last shape should match the foot shape, as well as a removable insole.