Any ideas as to why most insurance companies don't cover orthotics?

[GraysMom]

How does this work with a prescription? When I have had orthotics done, my podiatrist makes molds/casts of my feet and then sends them off. I've never had a prescription written up.

Also, I started out at an orthopedic surgeon for my ankle/foot issue and they referred me out to a podiatrist. The ortho said that podiatrists are really much better qualified for foot issues; unless you happen to stumble upon an ortho who has a sub-speciality in feet. Or they keep a podiatrist on staff.

I have prescription orthotics as well and they are simply custom casted made-for-my-feet-only. All of mine (from a podiatrist) have cost $500/pair and insurance doesn't cover any of it

 

[Kathi OD]

Can't answer your question, but your insurance pays for a Chiropractor? I think I have had 5 difference health insurance companies over the last 30 years, and none ever covered Chiropractors.

Our insurance pays for a chiropractor. Both DS and DH go to a chiro on a regular basis. $10 co-pay per visit.

 

[Kathi OD]

I don't think that custom orthotics are too much better than otc ones. What about http://www.footmapping.com/footmapping/home/index.jspa maybe that will do?

All I know is that the Dr. Scholl's OTC orthotics did absolutely nothing for me and my aching feet. Figured I would start there, since they are less expensive than those from a podiatrist. I've been using them for over 6 months. Just recently, I made an appointment with the podiatrist since nothing has improved.

 

[mamamary]

Over the years we have had some insurance cover them and some not cover them. Currently ours covers them so we were able to save a few hundred dollars this time.

 

[aprilgail2]

Can't answer your question, but your insurance pays for a Chiropractor? I think I have had 5 difference health insurance companies over the last 30 years, and none ever covered Chiropractors.

My insurance has always covered Chiropractors- just have to pay a regular co-payment.

OTC orthodics are NO WHERE close to custom ones! I am glad my insurance pays for a new ones each year- they cover a regular pair and a pair for dress shoes every year. I have a heel spur so bad that I had so much trouble walking, tried over the counter and they didn't work but once I had the custom ones made I don't have any pain anymore!

 

[The Mystery Machine]

I have custom orthotics and my insurance paid for them( blue cross/blue shield). My prescription did come from an orthopedic surgeon, maybe that makes a difference. I have mine b/c of a prior foot surgery after I fell. I love my inserts and would pay oop for mine just to help my foot pain.

I know my sister had her brace and orthotics covered before her surgery, however they would never cover her shoes. She has to get 2 pairs of custom made shoes.

She lived in a lot of pain for a long time and finally went to a better doctor who did ankle reconstruction surgery on her. That was not an easy recovery and she had another surgery since then.

They still do not cover her shoes. She did get her latest pair of shoes from a NEW BALANCE store. They have a foot specialist on staff that works with people with her issues. She was SO excited to be able to wear a pair of tennis shoes.

The doctor group she goes to specializes in ankle, foot, and knee surgeries only. They are specialized orthopedic surgeons. Let me tell there is something to be said for a group of doctors doing the latest techniques.

 

[DVC-Don]

Mine covers them. Blue Cross/Blue Shield. Podiatrist wrote the script.

 

[daughtersrus]

How does this work with a prescription? When I have had orthotics done, my podiatrist makes molds/casts of my feet and then sends them off. I've never had a prescription written up.

Also, I started out at an orthopedic surgeon for my ankle/foot issue and they referred me out to a podiatrist. The ortho said that podiatrists are really much better qualified for foot issues; unless you happen to stumble upon an ortho who has a sub-speciality in feet. Or they keep a podiatrist on staff.

Besides searching under Durable Medical Equipment, you could try under Orthotist. My DD wears AFO braces on her feet/legs and has worn a TLSO (for kyphosis and scoliosis). Shriners Hospital contracts with a local orthotist that makes all of the orthotics for their patients.

 

[MegUSN1]

Don’t go to an Orthopedic Surgeon for foot issues. I learned that the hard way. I had a bone spur filed down on my big toe (Hallux) in 2011. At the same time I had calf lengthening done. Now fast forward to 2018 and I am seeing a Podiatrist because I have Hallux Limitus (degenerative arthritis) with very limited mobility in that toe and the Orthopedic Surgeon missed some of the bone spur. Currently, my foot is taped. I was going to try orthotics only to find out today that GEHA doesn’t cover it. My only other option is surgery and I was trying to avoid it this time. But I am tired of being limited in having an active lifestyle because of a painful swollen big toe that won’t bend properly.

 

[tasha99]

I have custom orthotics, and insurance paid for them with no prescription. They've been wonderful--back and leg pain gone. I have different insurance now, though, and want another pair--unsure if they'll pay or not. I'm pretty much set on using the same orthotic maker, as she was very much an artist about it and they worked so well.

 

[bgirldeb]

Zombie thread!

 

[_19disnA]

Have you called your insurance company to verify if you are covered or not? I would start there. It depends on what insurance you have,

I agree. With the wide variety of medical coverage being offered by various employers, it is difficult to make generalizations about what they may/may not cover.

 

[FlightlessDuck]

Because all insurance companies are trying to make money.