Does Medicare Cover Bunion Treatments? - Foot & Ankle Centers (2024)

Bunions (also known as hallux abducto valgus) are a painful, debilitating condition caused by a bony protrusion at the base of the big toe. If left untreated, the bunion will continue to grow over time, eventually leading to permanent foot disfigurement. That’s why seeking corrective treatment, including bunion surgery, is essential.

Considering the importance of rectifying this chronic condition, understanding whether Medicare covers bunion treatments is of paramount importance. If your physician or podiatrist has recommended bunion surgery (or another form of treatment), you need to know if Medicare will cover the cost – and what specific surgeries are included in their coverage.

In this post, we’ll answer the question, “does Medicare cover bunion treatments?” We’ll explain the main types of bunion surgery and the other relevant information.

Does Medicare cover bunion treatments?

Yes. Under Medicare Part B, patients are covered for 80% of medically necessary bunion surgical procedures. They’re also covered for any medically necessary supplies either in a doctor’s office or outpatient setting and any visits to see the podiatrist.

However, if you decide to proceed with bunion surgery, you must pay the remaining 20% of the final approved cost. In addition, you may also need to pay a copayment in certain situations, and the Part B deductible will apply.

The average cost of bunion surgery in the United States is approximately $5,500 – although costs can range from $3,500 to $12,000. That means patients can expect to pay anywhere from $700 to $2,400: a sizable amount for most individuals.

The final cost is likely to depend on where you live, your insurance coverage, the type of procedure, and your present state of health.

What are the types of bunion surgery?

The surgical removal of a bunion is known as a bunionectomy. Most commonly, this operation is performed in an outpatient setting, as there is no need for general anesthetic, only local anesthetic. Surgeons typically use an ankle block designed to numb the leg below the knee.

There are more than forty different kinds of bunion removal surgery – the one your surgeon selects will depend on the size and development of the bunion. The three primary bunion removal surgeries include:

  • Osteotomy involves the surgeon cutting the big toe joint and realigning the bone to correct any deformity.

  • Exostectomy involves the surgeon removing the bunion without the subsequent realignment.

  • Arthrodesis involves the wholesale removal of the damaged joint and replacement with screws and metal plates. This operation is selected when other techniques cannot correct the bunion-induced deformity.

Following the surgery, the foot must be protected until the bones have fully healed. Your surgeon or podiatrist will most likely advise wearing a boot or cast and using crutches as walking aids until the foot has fully healed.

Other aftercare instructions include:

  • Elevating the foot for a set period daily.

  • Keep the foot dressing or cast dry during showers by wrapping it in plastic.

  • Monitoring for signs of infection.

  • Prescribing over-the-counter (OTC) pain medication to relieve any postoperative discomfort.

  • Avoid strenuous exercise or physical activity while the foot heals.

Depending on your age, general recovery should occur within six to eight weeks; full recovery can take between four to six months. After you’ve fully recovered, a series of physical therapy sessions are advised to strengthen the now weakened foot and ankle.

How to avoid bunion recurrence

Once your bunion is corrected, you don’t want the bunion to recur. After all, it’s a painful and disabling condition. Nor do you want to ask, “does Medicare cover bunion treatments?” again.

In some rare cases, however, bunion surgery can fail. That could be due to a surgical error, poor healing, or an unknown reason.

Signs and symptoms of a failed bunion surgery include:

  • Shorter big toe

  • Arthritis development in the big toe joint

  • Big toe joint stiffness

  • Bunion recurrence

After the surgery, you should wear comfortable, correctly fitting shoes going forwards. Bunions are primarily caused by ill-fitting footwear that bunches the toes together, e.g., high heels.

Final thoughts

Let’s recap: Does Medicare cover bunion treatment? Yes. Medicare Part B covers 80% of your bunion surgery, alongside any medically necessary supplies and podiatrist visits. The final 20% will either be paid for by the patient or covered by another insurance policy.

In addition to this 20%, patients may also be required to pay copayments for certain medical procedures and visits.

Bunions are a highly treatable podiatric condition affecting tens of millions of Americans annually. Through corrective surgery, people can go on to live a normal, active life.

Speak to our team about bunion surgery if you struggle with this debilitating condition.

Does Medicare Cover Bunion Treatments? - Foot & Ankle Centers (2024)

FAQs

Does Medicare Cover Bunion Treatments? - Foot & Ankle Centers? ›

Original Medicare provides coverage for treatment by a podiatrist that is considered medically necessary. Medically necessary podiatry services include treatment of hammertoe, heel spurs, bunion deformities or other medical conditions affecting the foot, ankle, or lower leg.

Will Medicare pay for bunion removal? ›

Let's recap: Does Medicare cover bunion treatment? Yes. Medicare Part B covers 80% of your bunion surgery, alongside any medically necessary supplies and podiatrist visits. The final 20% will either be paid for by the patient or covered by another insurance policy.

Is bunion surgery considered routine foot care? ›

ROUTINE FOOT CARE involves, but is not limited to hygiene and maintenance care (e.g., cleaning and soaking of feet, use of skin creams to maintain skin tone); trimming of nails (except surgery for ingrown nails); treatment of corns, calluses, keratoses; treatment of bunions (except capsular or bone surgery); and ...

How many podiatry visits does Medicare cover? ›

Medicare will help cover 1 foot exam per year if you have diabetes‑related lower leg nerve damage that can increase the risk of limb loss. However, Medicare will only cover the exam if you haven't seen a foot care professional for another reason between visits.

How to get orthotics covered by Medicare? ›

Are Custom Foot Orthotics Covered by Medicare? Custom foot orthotics are covered by Medicare Part B if ordered for you by a physician or nurse practitioner for a specific medical condition. Your healthcare and the orthotic supplier must participate in the Medicare program for your orthotics to be covered.

How do you qualify for bunion surgery? ›

You may need bunion surgery if you have severe foot pain that happens even when walking or wearing flat, comfortable shoes. Surgery may also be needed when chronic big toe inflammation and swelling isn't relieved with rest or medicines.

Can a podiatrist fix a bunion without surgery? ›

Other non-surgical treatments for bunions include injections of cortisone or oral anti-inflammatory medication and wearing custom-made shoes that accommodate the bunion deformity.

What is the Medicare policy for routine foot care? ›

Medicare doesn't usually cover routine foot care.

How long do you have to be off your feet for bunion surgery? ›

How long should you stay off your feet after bunion surgery? For every foot surgery, patients should stay off their feet and rest for the first two weeks. Typically, it is recommended that you keep the surgical area elevated 80% of the time during the first week and 50% of the time in the second week.

Should a podiatrist do bunion surgery? ›

For individuals experiencing bunions or other conditions affecting the feet, a podiatrist is well-equipped to treat them with a host of non-interventional and surgical treatments, developing a customized treatment plan for each patient.

Does Medicare cover a podiatrist cutting your toenails? ›

The cutting of toenails in a healthy person or when they are not painful is not a payable service by Medicare. The cutting of corns and calluses in a healthy person is not a payable service by Medicare. Legally, your podiatrist cannot try to obtain Medicare payment for noncovered foot care.

Does Medicare pay 100% of doctor visits? ›

Medicare Part B covers 80 percent of the cost of doctor's visits for preventive care and medically necessary services. Not all types of doctors are covered. In order to ensure coverage, your doctor must be a Medicare-approved provider.

Does Medicare cover toe fungus? ›

How Medicare Can Help Medicare Part B (Medical Insurance) may help cover medically necessary services, including doctor visits and care you receive in an outpatient setting, to diagnose and treat infections such as toenail fungus.

Will Medicare pay for Hoka shoes? ›

Medicare will only cover your therapeutic shoes if your doctors and suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare.

Does Medicare pay for ankle foot orthosis? ›

The specific conditions covered by Medicare include severe foot disease and diabetes. Orthotics are covered under Part B. Technically, orthotics are considered part of the durable medical equipment (DME) bracket, including: Bracing for ankle, foot, knee, back, neck, spine, hand, wrist, and elbow.

Can a podiatrist write a prescription for orthotics? ›

Today's podiatrist is the most experienced medical professional to prescribe orthotics. True. Podiatrists are the only physicians who focus exclusively on the foot and ankle. They are uniquely qualified to diagnose and treat foot-related problems.

How much does it cost to cut off a bunion? ›

Bunion correction surgery — also known as bunionectomy — usually costs about $6,000 or more per foot. Factors such as the complexity of the procedure and your insurance status will affect what you pay.

Why won't my insurance cover bunion surgery? ›

Some insurance companies will only cover the procedure if you have a severe bunion, or if it is impacting other medical conditions. You will also need your podiatrist to certify that the procedure is medically necessary.

How much is Lapiplasty with Medicare? ›

Lapiplasty cost with medicare can be anywhere from $3,000 to $15,000+ but it all depends on your specific medicare plan.

Is bunion removal surgery worth it? ›

The majority of patients are very happy with their bunion operation. Assuming the patient follows the postoperative instructions carefully, the outcomes are very good. There are risks of bunion surgery, however. Delayed bone healing can occur with any foot surgery, but this is rare.

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