Does Medicare Cover a Walking Boot?

This article details how Medicare covers walking boots, clarifies associated financial responsibilities, and outlines the steps involved in acquiring one.

Medicare Coverage for Walking Boots

A walking boot is categorized by Medicare as Durable Medical Equipment (DME). DME refers to items that are durable, used for a medical reason, generally not useful to someone without an illness or injury, and appropriate for use in the home. Medicare Part B, which covers outpatient medical services, provides coverage for DME, including walking boots.

For a walking boot to be covered, it must meet specific criteria, including medical necessity. A Medicare-enrolled physician or other authorized healthcare provider must prescribe the boot for use in your home, documenting its necessity to treat an illness, injury, or condition. Walking boots are typically covered for immobilization as treatment for an orthopedic condition or following orthopedic surgery. Coverage generally excludes boots used primarily for pressure relief or foot ulcers, unless it qualifies as a therapeutic shoe for individuals with diabetes.

Understanding Financial Responsibilities

When obtaining a Medicare-covered walking boot, beneficiaries typically have financial responsibilities under Medicare Part B. After meeting the annual Part B deductible, which is $257 in 2025, individuals are generally responsible for a 20% coinsurance of the Medicare-approved amount. Medicare pays the remaining 80% of the approved cost.

The supplier’s participation in Medicare significantly impacts out-of-pocket costs. Confirm that the DME supplier accepts Medicare assignment. When a supplier accepts assignment, they agree to accept the Medicare-approved amount as full payment, charging only the beneficiary’s deductible and coinsurance. If a supplier does not accept assignment, they may charge more than the Medicare-approved amount, making the beneficiary responsible for the difference in addition to their coinsurance and deductible.

Medicare Advantage (Part C) plans offer an alternative to Original Medicare. While these plans cover walking boots, their cost-sharing structures, such as deductibles, copayments, and coinsurance, may differ from Original Medicare. Medicare Advantage plans often have specific network rules, requiring beneficiaries to use in-network suppliers for the lowest costs. Consult your specific Medicare Advantage plan for details on their coverage and network requirements.

Obtaining Your Walking Boot

Acquiring a Medicare-covered walking boot begins with obtaining a valid prescription from a Medicare-enrolled physician. This prescription must clearly state the medical necessity for the walking boot and how it will treat your condition or injury. The physician’s medical records should also contain detailed chart notes supporting the device’s need for Medicare coverage.

Once you have a prescription, find a Medicare-approved Durable Medical Equipment (DME) supplier. You can locate approved suppliers using the directory on Medicare.gov or by calling 1-800-MEDICARE. Before finalizing any purchase or rental, confirm with the supplier that they accept Medicare assignment for the specific walking boot you need.

Some DME may require prior authorization from Medicare before coverage. Your supplier should inform you if prior authorization is necessary for your device. If required, the supplier typically handles the submission of the prior authorization request. Maintaining copies of all relevant documentation, including your prescription, the detailed written order, and any prior authorization approvals, is advisable for your personal records.