Diabetic Shoes for Women and Men Over 60: What Medicare Covers and What to Wear Instead

A podiatrist mentions extra-depth shoes. A pharmacy flyer advertises diabetic shoes, and an online listing puts the word diabetic in the name of a sandal.

Those three do not mean the same thing.

If you are a senior with diabetes looking at diabetic shoes for women or men’s diabetic shoes, the first question is not which brand. It is whether your feet need a prescribed therapeutic shoe or a well-fitting everyday one.

If you are a caregiver, you may be the one who spots the red mark on a heel, or the sock that came off with a small stain on it.

This guide covers what Medicare Part B pays for and who qualifies. It also covers how to choose an everyday shoe when the feet do not need a prescription yet.

Quick Answer: What Are Diabetic Shoes, and Does Medicare Pay?

In the medical sense, diabetic shoes are therapeutic shoes: extra-depth or custom-molded shoes with special inserts, fitted in person by a qualified supplier. Medicare Part B covers one pair a year, plus inserts, for people with diabetes who also have a qualifying foot problem such as a past ulcer, a deformity, poor circulation, or nerve damage with calluses.

Shoes sold in stores or online as diabetic are a different thing, and Medicare does not pay for them.

Everyone else with diabetes needs a shoe that matches the length, width and depth of the foot. The NIDDK adds that shoes and socks belong on the feet at all times, even indoors.

What Diabetic Shoes Actually Are

On a store shelf, the phrase has no fixed meaning. In Medicare’s rules it means one of two kinds of therapeutic shoe.

• Extra-depth shoes. CMS calls these depth shoes, with at least 3/16 of an inch of added depth once the filler inside is removed, leaving room for a molded insert.
• Custom-molded shoes are built over a model of the person’s own foot, and Medicare covers them when a deformity cannot fit in a depth shoe.

The inserts matter as much as the shoe. CMS describes them as total-contact, removable inlays molded directly to the patient’s foot.

A supplier also has to evaluate the feet in person before choosing the shoes, and check the fit when they are delivered.

That fitting step is the real difference. A store shoe can have a roomy toe box, but nobody has measured your foot against it.

Do You Need Them? Start With Your Risk Level

About half of all people with diabetes have some kind of nerve damage, according to the CDC. Many do not know it, since the NIDDK notes you can have a foot problem and feel no pain at all.

The International Working Group on the Diabetic Foot (IWGDF) publishes international guidelines on preventing foot ulcers, and it sorts people into four risk levels.

• Risk 0, very low: no loss of protective sensation and no peripheral artery disease (PAD). Screening once a year.
• Risk 1 means one of the two, either loss of protective sensation or PAD, rechecked every 6 to 12 months.
• Risk 2: both of those, or either one plus a foot deformity, checked every 3 to 6 months.
• At risk 3, sensation loss or PAD comes with a past foot ulcer, an amputation, or end-stage kidney disease. Checks happen every 1 to 3 months.

Loss of protective sensation means the foot no longer feels enough to warn you about a pebble in the shoe or a seam that rubs.

IWGDF suggests considering extra-depth shoes, custom footwear or custom insoles at risk 2 or 3 when a deformity raises pressure or a pre-ulcer has formed. After a healed ulcer on the sole, it strongly recommends prescribed footwear that relieves pressure, worn indoors and outdoors.

For people at risk 1 to 3 without those problems, its advice is simpler: footwear that fits properly and accommodates the shape of the feet.

If you are a caregiver and do not know a parent’s risk level, ask at the next diabetes visit. The answer decides which half of this article applies.

Medicare Coverage for Diabetic Shoes: Who Qualifies and What Part B Pays

Medicare.gov says Part B covers therapeutic shoes if you have diabetes and severe diabetes-related foot disease. The CMS rules spell out what counts, and the record has to show at least one of these.

• An earlier amputation of the other foot, or of part of either foot
• A past foot ulcer on either foot
• A history of pre-ulcerative calluses
• Peripheral neuropathy with evidence of callus formation. Both parts have to be there.
• A deformity of either foot, such as hammertoes or a bunion
• Poor circulation in either foot

Notice what is missing. Numb feet alone do not qualify under that list unless calluses are forming too.

Each year, Part B covers either one pair of extra-depth shoes with 3 pairs of inserts, or one pair of custom-molded shoes with 2 extra pairs of inserts. Medicare may also cover separate inserts or shoe changes in some cases.

Getting them takes several people, in this order.

1. The doctor who treats your diabetes certifies the need. CMS requires an in-person visit about diabetes care within 6 months before the shoes are delivered.
2. A podiatrist or other qualified doctor orders the shoes or inserts.
3. A supplier, such as a pedorthist, orthotist, prosthetist or podiatrist, evaluates your feet and fits the shoes.
4. Everyone involved must be enrolled in Medicare, or Medicare will not pay.

You pay 20 percent of the Medicare-approved amount after the Part B deductible, which is $283 in 2026. A supplier who accepts assignment can charge only that coinsurance and deductible, while one who does not has no limit on what they can charge.

So ask one question before anything is fitted: do you accept Medicare assignment for therapeutic shoes?

Paperwork is where these claims tend to fall apart. CMS reports a 2024 improper payment rate of 47.1 percent for therapeutic footwear, with insufficient documentation behind 85.5 percent of those errors.

Caregivers can help here by calling the diabetes doctor’s office to confirm the certification was signed and sent to the supplier.

You will see shoes advertised as Medicare approved. What Medicare actually approves is a claim: the right diagnosis, the right paperwork, and an enrolled supplier.

One related benefit is easy to miss. If diabetic neuropathy has caused loss of protective sensation, Part B also covers a foot exam every 6 months, as long as you have not seen a foot care professional for another reason in between.

What the Research Says About Therapeutic Shoes

Therapeutic shoes are not a guarantee, and two trials show why.

In a 2002 trial published in JAMA, Reiber and colleagues gave 400 people with diabetes and a past foot ulcer either therapeutic shoes with inserts or their usual footwear. After two years, new ulcers appeared in 14 to 15 percent of the shoe groups and 17 percent of the usual-footwear group, which was not a significant difference.

The authors pointed out that their participants did not have severe foot deformity. For that group, they found no evidence to support handing therapeutic shoes to everyone with an ulcer history.

A 2013 trial by Bus and colleagues tested custom shoes designed to relieve pressure in 171 people with neuropathy and a recently healed ulcer on the sole. Across everyone, ulcers came back in 38.8 percent with the improved shoes and 44.2 percent with usual care, again not a significant difference.

Among people who wore the shoes at least 80 percent of the time, the numbers split: 25.7 percent against 47.8 percent.

So here is the honest version. Prescribed footwear earns its place for people with a healed ulcer or a high-pressure deformity, and only on the days it is actually worn.

Diabetic Shoes for Women and Men’s Diabetic Shoes: What Changes

The Medicare rules are identical for women and men. The fit problems often are not.

The NIDDK warns against pointed toes and high heels for anyone with diabetes, because both put too much pressure on the toes. For women, that advice covers the dress shoe saved for church or a wedding, not just the everyday pair.

For men, width tends to be the sticking point, and a common fitting mistake is buying a longer size to get room across the front. FootCareMD says the ball of the foot should fit comfortably in the widest part of the shoe, so ask to be measured for width.

Either way, ask to be measured for width as well as length.

If you are a caregiver shopping for a parent, trace both feet on paper while they stand, and do it late in the day. The NIDDK advises buying shoes at the end of the day, when feet are largest.

If You Do Not Qualify Yet: Diabetic Shoes With a Wide Toe Box, and Other Things to Check

If you do not qualify yet, fit still matters. For people at IWGDF risk 1 to 3 without a deformity or ulcer history, the guideline says footwear should fit properly and accommodate the shape of the feet.

When you try on a pair, check these.

• Enough length that the longest toe does not touch the end when you stand
• A rounded, roomy toe box. Pointed toes are on the NIDDK’s list of shoes to avoid.
• Depth over the toes, so nothing presses on a curled knuckle. Our guide to managing a hammertoe without surgery explains why depth matters as much as width.
• A smooth lining. The CDC and NIDDK both say to check the inside of the shoe for rough spots and objects before putting it on.
• Laces or hook-and-loop straps, which hold the foot in place and let the fit loosen a little if feet swell
• No vinyl or plastic uppers, another NIDDK caution

For daily wear, the NIDDK suggests walking shoes or athletic shoes. Our guide to choosing footwear that helps prevent falls covers grip and fit in more detail.

A closed shoe with an extra-wide front and a smooth lining covers much of that list for someone whose feet still feel normally.

One caution about the pick below. It is sold as a barefoot-inspired shoe, and the listing does not say how thick the sole is.

IWGDF cites studies showing higher pressure under at-risk feet when walking barefoot, in socks, or in thin-soled slippers, so anyone with numbness should be fitted by a professional. People with big toe arthritis are often advised a firmer sole too, as our guide to hallux rigidus and big toe arthritis explains.

Sandals, Slippers, and Bare Feet at Home

Here the guidance gets strict. IWGDF tells anyone at risk 1 to 3 not to walk barefoot, in socks without shoes, or in thin-soled slippers, indoors or out.

Its reasoning extends the warning to any other open type of footwear that raises the risk of skin damage from a foreign object. The guideline says no study has directly measured ulcer risk from walking barefoot, in socks or in thin slippers, but at-risk feet show higher pressure on the sole in all three.

The CDC’s consumer advice is a little looser, allowing shoes and socks or slippers inside. For anyone with numb feet, the stricter IWGDF line is the safer one.

So can someone with diabetes wear sandals?

The IWGDF warning is aimed at risk 1 to 3. If your feet have normal feeling and good circulation, ask your doctor before choosing an open sandal, and check your feet every evening.

If that describes you, look for straps that adjust snugly and a toe area with room, and skip any sandal your foot slides around in.

Neither card is a Medicare therapeutic shoe, and neither replaces a fitting for someone who qualifies.

If you are a caregiver and a parent with numb feet loves a pair of sandals, offer a closed shoe that is just as easy to put on. That works better than a lecture.

Daily Foot Checks: The Part No Shoe Replaces

No shoe does the job of looking. The CDC advises checking the feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any change to the skin or nails.

A mirror on the floor helps with the soles, and so does a second pair of eyes.

Break new shoes in slowly. The CDC suggests an hour or two a day at first, followed by a look at the feet for sore spots.

Socks with no seams are best, according to the NIDDK.

If you are a caregiver, tie the check to something that already happens, like taking shoes off after a walk. It feels less like an inspection that way.

Numb feet affect balance as well as skin. Our guide to exercises for peripheral neuropathy includes foot and balance work you can start seated.

Warning Signs That Cannot Wait

Charcot foot is a rare but serious complication in which the bones and joints of a numb foot weaken and can collapse. Cleveland Clinic lists its early signs as foot pain, redness or discoloration, swelling, and one foot feeling noticeably warmer than the other.

Because numb feet can make pain hard to feel, a warm, red or swollen foot still needs a call to the doctor.

Call the doctor promptly for any of these.

• A change in the shape of the foot
• A wound, discoloration, warmth or an unusual smell. Cleveland Clinic names all four as reasons to contact a provider right away.
• A cut or sore that looks infected or will not heal, which Mayo Clinic flags for anyone with diabetic neuropathy
• New numbness, tingling or burning in the feet, especially at night

Smaller problems still deserve care with diabetes. Our guide to common foot problems in older adults covers safe corn and callus care.

What a Doctor Will Typically Check

A foot exam for diabetes is mostly hands-on, and it follows the same checks IWGDF uses to set the risk level.

• Feeling, tested with a 10-gram monofilament, or with the Ipswich Touch Test when no monofilament is on hand
• Vibration sense, using a tuning fork
• Circulation. That starts with feeling for foot pulses and can include Doppler waveforms and ankle or toe pressure measurements.
• Skin, nails, calluses and any deformity, such as hammertoes or a bunion
• The shoes and socks actually worn day to day

A physical therapist can add a look at walking and balance, which matters more once feeling in the feet starts to fade.

If you are a caregiver, bring the shoes your parent wears around the house, not the good pair by the front door. Worn spots inside a slipper tell the clinician where pressure lands.

What NOT to Do

• Do not assume a shoe labeled diabetic is a Medicare therapeutic shoe. Store shoes, including the ones in our cards, are not.
• Do not walk barefoot or in socks alone at home if feeling in the feet is reduced.
• Do not save prescribed shoes for outings. In the Bus trial, fewer ulcers came back in the people who wore them at least 80 percent of the time.
• Do not wear a brand-new pair all day on the first day.
• Do not wait out a warm, swollen or red foot, even if it does not hurt.

Frequently Asked Questions

Does Medicare pay for diabetic shoes?

Yes, if you have diabetes plus a qualifying foot condition and the certification, order and supplier rules are met. You pay 20 percent of the approved amount after the Part B deductible.

Are diabetic shoes sold in stores Medicare approved?

Not on their own. Medicare pays only when an enrolled supplier fits you after your doctors certify and order the shoes.

Are extra wide or non-slip shoes the same as diabetic shoes?

No. Width and grip are useful features, but a therapeutic shoe also has extra depth and molded inserts, and it is fitted by a professional.

Can people with diabetes wear sandals?

With numb feet or poor circulation, closed shoes are the safer choice under IWGDF guidance. With normal feeling, ask the doctor, and check the feet every evening.

My mother has diabetic shoes but takes them off as soon as she gets home. Does it matter?

It does. IWGDF advises wearing prescribed footwear indoors and outdoors, and the Bus trial saw fewer ulcers in people who wore theirs at least 80 percent of the time.

Ask the doctor or supplier what to wear around the house, since the shoes only help when they are worn.

Do women’s and men’s diabetic shoes follow different Medicare rules?

No, the benefit is the same. The difference is fit, so ask the supplier to show styles you will actually wear every day.

Final Thoughts for Adults Over 50

The word diabetic on a shoe box tells you very little. Your risk level tells you a lot, and it comes from a hands-on foot exam.

If you are a senior with diabetes, find out your level, then match the shoe to it. A qualifying foot deserves a fitted shoe that you wear all day, and a low-risk foot deserves one that fits its real length, width and depth.

If you are a caregiver, the quiet jobs count most here: a look at the feet each evening and a call to confirm the paperwork went through.

Medical Disclaimer

This article is for general education and does not replace personalized medical advice. Anyone with diabetes should have their feet examined regularly, and footwear decisions for people with numbness, poor circulation, deformity or a past ulcer belong with a physician, podiatrist or certified footwear specialist.

Seek prompt medical care for a foot that becomes red, warm, swollen or changes shape, or for any sore that does not heal.

You Might Also Be Wondering

• How to pick safe shoes and slippers that lower fall risk, including what makes an outsole grip.
• What causes swelling in the legs and feet, and which kinds need a doctor quickly.
• Balance exercises you can do safely at home, useful when feeling in the feet is fading.

Medical References

1. Medicare.gov. Therapeutic shoes and inserts.
2. Medicare.gov. Foot care for diabetes.
3. Medicare.gov. Medicare costs (2026).
4. Centers for Medicare & Medicaid Services, Medicare Learning Network. Medicare Provider Compliance Tips: Therapeutic Footwear.
5. Centers for Medicare & Medicaid Services. Local Coverage Determination L33369: Therapeutic Shoes for Persons with Diabetes.
6. Bus SA, Sacco ICN, Monteiro-Soares M, et al. Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update). Diabetes Metab Res Rev. 2024;40(3):e3651.
7. Reiber GE, Smith DG, Wallace C, et al. Effect of therapeutic footwear on foot reulceration in patients with diabetes: a randomized controlled trial. JAMA. 2002;287(19):2552-2558.
8. Bus SA, Waaijman R, Arts M, et al. Effect of custom-made footwear on foot ulcer recurrence in diabetes: a multicenter randomized controlled trial. Diabetes Care. 2013;36(12):4109-4116.
9. Centers for Disease Control and Prevention. Diabetes and Your Feet.
10. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes and Foot Problems.
11. Cleveland Clinic. Charcot Foot.
12. Mayo Clinic. Diabetic Neuropathy: Symptoms and Causes.