Product guidance · Footwear
Shoes for diabetes: the benefit most people never hear about
If you have diabetes and qualifying foot changes, Medicare covers a pair of shoes and three pairs of inserts every year. A great many people who qualify are buying their own instead.
Written by the Managing Neuropathy editorial team under the direction of Dr. Tom Biernacki, DPM, FACFAS · Clinical review pending · Last updated 6 September 2026
The short answer. Start by finding out whether you qualify for Medicare’s Therapeutic Shoe Benefit — it is the best value in this entire category and it is routinely missed. If you are buying privately, the features that matter are depth, true width sizing, a seamless interior, an adjustable closure and a protective sole. And the reason any of it matters is wound prevention, not comfort.
Why diabetes changes the footwear question
Three things stack up. Nerve damage means you may not feel a shoe rubbing. Circulation changes mean that when skin does break down, it heals slowly. And a higher infection risk means a small wound can escalate in a way it would not in a healthy foot.
So footwear stops being about comfort and becomes about preventing a wound that starts silently. That reframing is the whole point: you are not shopping for how a shoe feels, you are shopping for whether it can quietly damage you.
The Medicare Therapeutic Shoe Benefit
For people with diabetes who meet specific criteria, Medicare Part B covers one pair of therapeutic shoes and three pairs of inserts per calendar year, or in some circumstances custom-moulded shoes. This is a long-standing benefit and it is dramatically underused.
Roughly who qualifies
You need diabetes, you need to be under a care plan for it, and you need at least one qualifying foot condition. Those conditions typically include a history of partial or complete foot amputation, a history of foot ulcer, a history of pre-ulcerative callus, peripheral neuropathy with evidence of callus formation, foot deformity, or poor circulation. Your clinician determines whether you meet them — the list above is orientation, not a self-assessment.
The detail that causes most failed claims. The physician who certifies that you have diabetes and meet the criteria must be the M.D. or D.O. managing your diabetes. A podiatrist cannot sign that certification — even though a podiatrist can write the prescription for the shoes and can fit and dispense them.
Certifying and prescribing are two separate roles. This surprises people, and it is why the process stalls. The practical consequence: start the conversation with the doctor treating your diabetes, not with a shoe shop. The certification also has to be dated within a defined window before the shoes are delivered, so sequence matters.
How to actually start it
At your next diabetes appointment, ask directly: “Do I meet the criteria for the Medicare therapeutic shoe benefit, and would you be willing to certify it?” If yes, you will also need a prescription and a supplier enrolled to provide them. Ask your clinician who they work with locally, since not every shoe retailer is an enrolled supplier.
If you have insurance other than Medicare, ask what your plan covers — many follow similar criteria.
If you are buying privately
The same features matter whether Medicare pays or you do.
| Feature | What to check |
|---|---|
| Depth | Room above the toes, not just in front of them. If the upper touches the top of your toe joints while standing, the shoe is too shallow. “Extra depth” is a real category worth searching by name. |
| True width sizing | Width as its own measurement — not a longer shoe. Sizing up for width lets the foot slide forward and increases friction. |
| Seamless interior | Run your hand inside. Every seam and stitched overlay is a ridge that will press on skin for hours. |
| Adjustable closure | Laces or wide hook-and-loop straps, so the fit can change as your foot swells through the day. |
| Firm heel counter | Squeeze the back. It should resist. A collapsing heel lets the foot move, and movement means shear. |
| Protective sole | Stiff enough not to fold in half. You may not feel what you step on. |
| Removable insole | Required if you use prescribed inserts or orthotics; otherwise they steal your depth. |
Fitting, when you cannot rely on feel
Fit the larger foot. Feet change shape over the years.
Swelling is real and thick socks change the fit.
If the tracing is wider than the shoe, it is too narrow — whatever it feels like.
Then take them off and inspect. Redness lasting more than an hour or two means damage you cannot feel.
Stones, folds, and objects that got in overnight are a classic source of injury.
Two habits worth more than the shoes
Never go barefoot, including indoors — most foot injuries in neuropathy happen at home, from stepping on something never felt. And look at your feet every single day: tops, soles, heels and between the toes. A daily check turns an invisible problem into a visible one, which is the entire game.
When to be seen rather than shop
Any open sore, blister, or crack that is not healing. Redness, warmth, swelling or drainage, especially with a fever. Any wound at all — with diabetes, a wound is a same-week matter, not a wait-and-see. And a foot that has suddenly become warm, swollen and changed in shape without an injury needs prompt attention.
Specific product recommendations
We have not published named picks here yet. Our editorial policy requires us to be able to say what was assessed and how. And in this category the honest first recommendation is not a product at all: find out whether the shoes are already covered for you.
Affiliate relationship: when picks are published, some links will be affiliate links and we may earn a commission from qualifying purchases at no additional cost to you. As an Amazon Associate I earn from qualifying purchases. See our affiliate disclosure.
Common questions
Are diabetic shoes ugly?
Far less than they were. Extra-depth footwear now comes in ordinary walking, dress and athletic styles. If the only pairs you are shown look orthopaedic, ask to see more.
Can I use my own inserts in them?
Yes, if the factory insole is removable. If you have prescribed orthotics, bring them to the fitting.
Do I need special shoes if I have diabetes but healthy feet?
Not necessarily. With normal sensation, good circulation and no deformity, well-fitting ordinary shoes may be fine — and you would not meet the Medicare criteria either. What settles it is a foot examination.
How often should I replace them?
The benefit runs annually for a reason: cushioning and support degrade well before the upper looks worn. Judging by appearance means walking on a flattened sole for months.
Related reading
Best shoes for neuropathy · Diabetic socks · Daily foot care
Sources and further reading: Centers for Medicare & Medicaid Services, Therapeutic Shoes for Persons with Diabetes — coverage criteria and certifying-physician requirements. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), diabetes foot-care guidance. American Diabetes Association Standards of Care, foot-care section.
Coverage rules change and individual eligibility is determined by your clinician and your plan. This page is general education, not a diagnosis, a treatment plan, or a guarantee of coverage. Clinical review by Dr. Biernacki is pending; the review date will be shown here once complete.
For our Michigan neighbors
Find out whether
you qualify.
Dr. Biernacki’s Michigan practice can examine your feet, document what is there, and tell you what the next step toward covered footwear looks like.
Everywhere else, ask your diabetes doctor about certification.
Dr. Tom Biernacki, DPM, FACFAS is a double board-certified foot and ankle surgeon (ABFAS and ABPM) and a Fellow of the American College of Foot & Ankle Surgeons. He is the founder of Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, where peripheral neuropathy, diabetic foot risk and loss of protective sensation are part of his weekly clinic. His patient education videos have drawn more than 950,000 subscribers on YouTube. He writes Managing Neuropathy to put the explanation he gives in the exam room in front of the people who cannot get to one — including when a product is worth buying and when it is not.