Orthopedic Shoes / Custom Orthotics
Orthopedic shoes and custom orthotics are specialized footwear and inserts designed to support proper alignment, relieve pain, and improve mobility for individuals with foot, leg, or posture-related conditions. These items are often prescribed to correct biomechanical issues, provide additional cushioning, or accommodate deformities caused by medical conditions such as arthritis, diabetes, or plantar fasciitis.
Most health insurance plans classify orthopedic shoes and orthotics as eligible medical equipment or supplies under extended health benefits. Coverage usually includes a set dollar maximum per year or every two benefit years and typically requires a prescription from a physician, podiatrist, or chiropodist. The policy may also specify that orthotics must be custom-made from a three-dimensional cast or scan of the foot to qualify for reimbursement.
Proper footwear and orthotics can significantly improve comfort and prevent secondary injuries by providing individualized support and promoting better body mechanics.
Example:
If your plan covers 80 percent of eligible expenses up to $400 every two years and your custom orthotics cost $500, your insurer reimburses $400 and you pay $100.
What to Watch For:
Ensure that your provider is recognized by your insurer and that the devices are custom-made rather than off-the-shelf. Some plans require itemized receipts, proof of casting, and pre-authorization. Replacement frequency limits and maximums may differ between orthotics and orthopedic shoes.
