FAQs for Australians: Are Diabetic Shoes Covered by Insurance？

Managing diabetes often means paying close attention to foot health — and for many people that includes specialised diabetic or orthopaedic footwear. But does insurance help cover the cost? Here’s what Australians need to know.

1. What counts as “diabetic shoes”?

Diabetic shoes or medical-grade footwear are specially designed shoes that:

• have extra width and depth

• allow space for custom orthotics

• reduce pressure points and friction (important for neuropathy or foot deformities)

• help prevent ulcers and serious foot complications

Not all “comfort shoes” qualify — they must be appropriate for clinical or therapeutic use.

2. Does Medicare cover diabetic footwear in Australia?

Generally, no.
Australia’s public healthcare system — Medicare — provides rebates for many health services, but it does not routinely pay for specialised footwear or diabetic shoes. Medicare rebates are primarily for medical consultations, allied health services, and clinical treatments. There’s no regular Medicare benefit for diabetic shoes themselves unless they are part of a funded allied health service.

3. Can private health insurance help pay for diabetic shoes?

Possibly — but it depends on your policy.

• Many private health funds include an “Extras Cover” category that may offer rebates for orthotics, allied health, and medical aids.

• Not all policies cover footwear or specific diabetic shoes — some only cover custom or prescription items.

• You typically need a referral or prescription from a podiatrist or other qualified clinician to claim.

• Coverage amounts, waiting periods, and item limits vary by insurer and level of cover.

📌 Tip: Ask your podiatrist for prescriptions or item codes when checking with your insurer — this makes claims easier.

4. Can the NDIS fund diabetic footwear?

Yes — but only in specific circumstances.
The National Disability Insurance Scheme (NDIS) provides funding for supports that are reasonable, necessary, and related to a permanent disability. In NDIS plans, that can include:

• specialised footwear

• custom shoes or modifications

• orthotics and other assistive technology related to foot health, if directly connected to your disability and helping you participate in daily life

Important:

• NDIS funding is not automatic for all people with diabetes — you must qualify for the NDIS first, with evidence that diabetes affects daily functioning and mobility.

• The NDIS will assess whether footwear is needed to help meet goals in your individual plan.

5. What about other government programs?

Additional avenues that might help include:

• Home Care Packages (HCP) — older Australians living at home with mobility issues may access funding for supportive footwear as part of their package.

• State community health programs — some regions provide subsidised orthotics or footwear for high-risk patients with diabetes, but this varies by location and eligibility.

6. Do I need a professional assessment or prescription?

Yes — in most cases:

• For private health insurance rebates, a referral or prescription is often required.

• For NDIS funding, documentation from clinicians is essential to demonstrate need.

This ensures the footwear meets clinical requirements and improves the chances of successful funding.

7. What parts are covered by Medicare or public healthcare?

While shoes themselves are not subsidised, Medicare may cover:

• Podiatry visits under the Chronic Disease Management Plan, which can include foot care and orthotic assessments.

8. How do I check what my insurance covers?

To confirm coverage:

1. Review your private health policy booklet under extras like “health aids,” “medical aids,” or “orthotics.”

2. Call your insurer with item codes or prescriptions from your clinician.

3. Ask your podiatrist or allied health provider whether they can submit a claim on your behalf.

Summary