Are Orthopaedic Shoes By Insurance?
Orthopedic shoes are covered under some supplemental insurance plans. However, each insurance company has their own stipulations about the types and brands of orthopaedic footwear that they will cover.
If you intend to claim orthopaedic footwear through your insurance company, it is very important that you verify directly with your insurance company which type of orthopaedic shoes you are covered for prior to your appointment. When checking your policy, please get the exact terminology for your footwear coverage, as this can greatly alter the requirements and eligible footwear you are covered for. This can include:
- Stock item orthopaedic footwear (available at Feet First Clinic)
- Modified orthopaedic footwear (available at Feet First Clinic)
- Custom-made orthopaedic footwear (not available at Feet First Clinic)
Insurance quotes for orthopedic footwear are recommended to ensure that specific makes and models are approved. We will prepare a quote for you to submit to your insurance company for pre-approval.
Feet First Clinic is not liable if your footwear claim is denied. If your footwear claim is denied after you purchase the shoes, you will not be able to return the shoes.
Please note: The footwear assessment fee is separate from the orthopaedic shoes. Footwear assessments are a chiropodist service and are covered by many private insurance plans. Chiropodist services are not covered by OHIP.
Understanding Your Footwear Coverage
There are three main types of orthopaedic footwear covered by insurance companies. Prior to your appointment, please check the exact terminology in your insurance policy to see which of the following types of orthopaedic footwear you are covered for:
- Stock Item Orthopaedic Footwear: Also referred to “off-the-shelf” orthopaedic footwear, these are orthopaedic shoes that can be purchased from stock (or “off-the-shelf”). No modifications or customizations are made.
- Modified Orthopaedic Footwear: This is stock item orthopaedic footwear with an added special modified insole. The chiropodist will take a foam mould of your foot and then list modifications to be made based on your foot condition. Once you select your shoe, we will send your shoe and the mold to the lab to make the modifications. We can also modify existing shoes purhased elsewhere. Some policies will only cover the modifications themselves; some will cover both the shoe and the modifications. Because the chiropodist needs to take a mold of your foot at your foot assessment, please let us know prior to or at your appointment if your policy requires modified footwear.
- Custom Made Orthopaedic Footwear: This refers to a custom-made shoe. Feet First Clinic does not offer custom made orthopaedic footwear.
Once you obtain your policy breakdown, feel free to contact us if you have any questions about the terminology in your footwear coverage.
Brands and Styles Covered by Insurance
Every policy is unique and varies from plan to plan, and between insurance companies. Most insurance companies cover orthopaedic footwear from the following companies (if you have coverage):
Some insurance companies and employers will cover other brands too. Most insurance companies do not cover open toe sandals or winter boots; however this may vary. To ensure your choice of footwear is covered, we recommend selecting multiple models. We will then prepare a quote with these models for you to submit to your insurance company for preapproval. That way, if your first choice is not approved, you have a back-up option.
After your foot assessment, when selecting shoes, we will size you in the brands covered by your insurance company. Once we know your size, you can select the shoes you want from a catalogue. Provided the shoe is in stock, we can order it in for you. We will order your shoe once we receive confirmation from you that you are pre-approved.
