FAQs for Australians: How Often Does Medicare Pay for Diabetic Shoes?

If you live with diabetes, foot care is a crucial part of managing your health. Medicare in Australia offers support for diabetic footwear, but many people are unsure about the details. Here’s a clear FAQ guide to help you understand how often Medicare can pay for diabetic shoes  and what you need to know.

1. Does Medicare cover diabetic shoes?

Yes. Medicare provides coverage for therapeutic footwear for people with diabetes who are at risk of foot complications. This includes custom-made shoes or extra-depth shoes designed to reduce pressure and prevent foot ulcers.

2. Who is eligible?

To qualify for Medicare-funded diabetic shoes, you must:

• Be diagnosed with diabetes.

• Be at risk of foot problems such as neuropathy, foot deformities, or a history of ulcers.

• Have a valid prescription or referral from a GP or accredited podiatrist.

3. How often can I get Medicare-funded diabetic shoes?

Medicare generally covers one pair of diabetic shoes per year for eligible patients. In some cases, if your foot size or medical condition changes significantly, your doctor or podiatrist may request earlier replacement, but this is assessed individually.

4. What costs does Medicare cover?

Medicare provides a partial rebate, not full coverage. The rebate typically covers a portion of the cost of the shoes and, if required, custom orthotic inserts. The exact amount varies depending on whether the shoes are standard extra-depth, custom-made, or include specialized orthotics.

5. Do I need a prescription?

Yes. A valid prescription from a doctor or an accredited podiatrist is required. This ensures that your shoes meet medical standards and are eligible for Medicare funding.

6. Can I choose any diabetic shoe?

Not all shoes qualify. To be eligible for Medicare funding, shoes must meet therapeutic footwear guidelines, including:

• Extra-depth design

• Soft, supportive materials

• Proper fit for foot shape and medical needs

Many brands specifically meet Medicare requirements, so check with your podiatrist before purchasing.

7. Can Medicare pay for shoe repairs or replacements?

Medicare usually does not cover repairs. Replacement shoes are considered under the one-pair-per-year guideline. If the shoes wear out prematurely due to your condition, discuss your situation with your podiatrist—they can submit a special request to Medicare.

8. Are inserts or orthotics covered?

Yes. Orthotic inserts prescribed for diabetic shoes are usually partially reimbursed by Medicare, along with your shoes. The amount depends on the type of insert and the provider’s fees.

9. How do I claim?

To claim:

1. Obtain a prescription from your GP or podiatrist.

2. Purchase your shoes from a provider that accepts Medicare rebates.

3. Submit the claim through Medicare or have the provider process it on your behalf.

10. Tips for getting the most from Medicare coverage

• Plan your purchase once a year to maximize your coverage.

• Keep all receipts and prescription documents.

• Consult a podiatrist regularly to ensure your shoes continue to meet your medical needs.

Bottom Line:
Medicare supports Australians with diabetes by partially covering one pair of therapeutic shoes per year. With the right prescription and provider, you can protect your feet, prevent complications, and make the most of your benefits.