What Are A5500 Diabetic Shoes?

You may have heard the term “A5500” when referring to shoes. But what does it mean? In this article, we will cover what exactly is an A5500 diabetic shoes and how you can qualify to be covered by Medicare for these types of shoes.

What is an A5500 Diabetic Shoe?

An A5500 shoe is an off-the-shelf shoe manufactured to accommodate particular needs for diabetics and that has met all the specifications to qualify for reimbursement through Medicare and other health insurances providers. The “A5500” is a standardized code used by these entities for healthcare claims. When you use the A5500 code, many aspects of your custom orthotics are covered, including the fitting, follow-up, and custom preparation and supply of diabetic shoes.

In order for a shoe to qualify as an A5500 diabetic shoe, the following requirements must be met:

1. Full length, heel-to-toe filler that can be removed to provide a minimum 3/16” additional depth. This added depth can accommodate customized inserts and/or foot conditions related to diabetes (swelling, ulcers, etc.).
2. Made of leather or other materials of equal quality. The qualified material provides adequate protection to the person’s foot. Generally, the heels and toes are the most common area for health issues of people with diabetes, so a substantial material helps to protect these areas.
3. Have some type of closure. The shoe must have a lace or adjustable strap closure and completely cover the foot. Sandals or open toed shoes are not acceptable. The closure should be able to be adjustable for a proper fit. This can prevent any small objects from entering the shoe during wear and accommodate swelling, if applicable. Ensuring the foot is enclosed helps reduce the foot to exposure of external elements that could harm or prevent adequate treatment of the foot.
4. Available in full and half sizes and three shoe widths. Since foot swelling is a common symptom of diabetes, the variety of sizes and widths can accommodate for this.

Obtaining Medicare Coverage for A5500 Diabetic Shoes

Under Medicare Part B (Medical Insurance), Medicare will cover one pair of custom-molded shoes and inserts or one pair of extra-depth shoes each calendar year. You can also be covered for 2 additional pairs of inserts for the custom-molded shoes or 3 pairs of inserts for extra-depth shoes. You are eligible to be covered under Medicare only if the doctor or supplier is enrolled in Medicare. If the doctor or supplier is not enrolled, Medicare will not cover the submitted claims.

Also, a podiatrist of other qualified doctor must verify you have diabetes or a diabetic foot condition and prescribe the shoes or inserts for you.

Make sure that you are using a supplier that accepts Medicare, and that your doctor can properly fit you for your therapeutic custom orthotics. Your doctor can help you get started with making the Medicare claim or you can reach out to Medicare directly for the reimbursement process.

The Benefits of Diabetic Shoes

Why do people with diabetes need therapeutic shoes? Even though diabetes is related to your blood sugar, it also affects your feet. Often, diabetics suffer from edema, loss of feeling in their extremities, and poor blood flow. Poor circulation can mean that cuts or sores on your feet don't heal as quickly. Then, those cuts can cause gangrene, ulcers, or other foot problems.

What Makes an A5500 Diabetic Shoe Different

Since A5500 diabetic shoes are made with extra depth and width, the added interior room can accommodate any swelling from increased blood supply. Some styles are made with stretch material that has a good amount of give for better accommodation and an adjustable fit. Also, the interior lining is also usually soft and seamless to reduce any irritation and provided extra comfort during wear. Many A5500 shoes are made with multiple layers of removable inserts so that you can adjust the depth of the shoe for your own orthotics or foot shape. This can help to reduce any pressure points and friction with the extra room inside the shoe.

Options for Diabetic Shoes

You might think that diabetic shoes are clunky, an eyesore, or that they don't consider different lifestyles. This couldn't be farther from the truth! Today, there are many Medicare approved footwear options that match different lifestyles and taste preferences.

Materials

Diabetic shoes are made with many different materials that not only support your foot condition but provide additional features that are beneficial to those with diabetes. Some of the materials and features can include:

• Waterproof uppers and construction - If you live near the water or take part in gardening, nature activities, or rainy day walks, then waterproof diabetic shoes are a must. They can keep your feet dry and preserve the integrity of the shoe.
• Multi-way stretch - Your shoes need to adjust to swelling and edema, so the more ways that they stretch, the better. Generally, lycra or knit fabric material is used at the toe box and instep area to provide more give where you need it most.
• Breathable uppers & insoles – Allowing airflow in the shoe is necessary to keep your feet dry and prevent odors. Most diabetic shoes are made with breathable, moisture wicking materials to promote good foot health. Some styles will have an anti-microbial lining to help eliminate bacteria and/or mold in the shoe.

Colors

You can even start a collection of diabetic shoes that go with anything in your wardrobe! No matter the color you like to wear, there's a shoe for you.

• Black - Black is classic! It also looks nice even after being worn day after day.
• White - White shoes are crisp and clean, making you look put together so you can feel your best.
• Gray - Gray shoes blend in well with everything you're wearing, no matter the activity.
• Brown - Classic brown slippers or sandals are perfect for all seasons.

Styles

Don't let diabetes slow you down! Exercising and staying active are key to managing your health. So, choosing diabetic shoes that cater to your lifestyles or occasion is key. A5500 shoes are offered in styles like:

• Tennis shoes - Sneakers are the ultimate in everyday wear. You'll get stability, durability, and convenience in our selection of tennis shoes.
• Hiking shoes - We have options for mid-level hikes that will transition easily into strolling and speed walking through your neighborhood.
• Casual shoes - Maybe you don't want to be in tennis shoes every day. Check out the casual options that can be dressed up and dressed down depending on the occasion.
• Slippers - You can even keep your feet healthy while staying cozy! Choose from styles with hook-and-loop strap closures for easy on and off and adjustability.

Brands

Most orthopedic shoe manufacturers offer A5500 coded shoe styles. Some of the most popular brands that offer these types of shoes include:

• New Balance
• Apex
• Drew
• Orthofeet
• Propét

Finding the Best Diabetic Shoes for You

Talk to your physician about choosing the best shoe for you. Persons with diabetes don't have to go through life with uncomfortable, unsightly, or unaffordable shoes. You can enjoy your footwear and still keep your feet healthy and comfortable, too.

Your physician can give you further information about using the appropriate code with your Medicare plan for your A5500 diabetic shoe.

About author:

Derek Roach is a foot health specialist and has worked in the foot health industry for over 10 years. He is knowledgeable in various foot conditions and shoe features to help with those conditions. Also, he has been quoted on CNN, The Penny Hoarder, HuffPost, Dapper Confidential and other popular publications for foot and shoe-related topics.