I'm looking for cheaper Orthotics alternatives

Posted by motorcarrier @motorcarrier, Jan 6, 2022

My podiatrist ordered orthotics to help with a fracrured 5th metatarsal in my left foot. He ordered what's called L3000 UCB type Berkley Shells. He ordered two, apparently one for each foot. These orthotics are $300 each and are not covered by Medicare or my Plan G supplement so I declined. Are there any alternatives to the one in the attached photo?

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I continuously keep fracturing my toes. Mostly pinky toe, but 5 toes in three years so I’m somewhat of an expert! Anyway, CVS or any pharmacy has a flat plastic splint that Velcro’s over your foot and makes it more comfortable to walk.

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@motorcarrier, you may be interested in this related discussion:
- How to buy an effective orthotic: https://connect.mayoclinic.org/discussion/how-to-buy-an-effective-orthotic/

Have you considered calling your insurance provider to ask them an alternative option that they cover?

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@pegleg27

I continuously keep fracturing my toes. Mostly pinky toe, but 5 toes in three years so I’m somewhat of an expert! Anyway, CVS or any pharmacy has a flat plastic splint that Velcro’s over your foot and makes it more comfortable to walk.

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After doing quite a bit of research, I bought this.

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@motorcarrier

After doing quite a bit of research, I bought this.

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That’s exactly what I used!

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I also use Medicare with a medicare supplement. I am a licensed insurance agent for 15 years and a RN Candidate in academic study. My suggestion is to appeal the Medicare ruling for not paying for the device. First you need a denial in writing from Medicare that the product is not covered. Then make a written appeal to your regional Medicare administrator, not a hospital or state entity. In the appeal, you need to explain the device and why it is needed in both clinical and lay terms. Your written appeal needs to address the issue in a point by point argumentative essay style format. I believe you can get the device. Best regards.

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@lbroomayo1

I also use Medicare with a medicare supplement. I am a licensed insurance agent for 15 years and a RN Candidate in academic study. My suggestion is to appeal the Medicare ruling for not paying for the device. First you need a denial in writing from Medicare that the product is not covered. Then make a written appeal to your regional Medicare administrator, not a hospital or state entity. In the appeal, you need to explain the device and why it is needed in both clinical and lay terms. Your written appeal needs to address the issue in a point by point argumentative essay style format. I believe you can get the device. Best regards.

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I appreciate the advice but the system and appeal process is designed to be so complicated and time consuming that most people opt for alternatives just as surgery or opioids.

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@pegleg27

I continuously keep fracturing my toes. Mostly pinky toe, but 5 toes in three years so I’m somewhat of an expert! Anyway, CVS or any pharmacy has a flat plastic splint that Velcro’s over your foot and makes it more comfortable to walk.

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I get cramps in my toes. I was a dancer and studied ballet in my youth and I love wearing high heeled shoes, pointed toe shoes, and boots. Senior bodies don't like my choices. I have learned homeopathic processes to protect the strength, flexibility, and condition of my feet. I nurse them daily in face cream, I use cortisone cream and antifungal powder on and between my toes. I also use toe separators found in nail salons to separate my toes for circulation while relaxing with my feet up. Don't forget to message them with a heating pad, it feels good! Best regards.

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@motorcarrier

I appreciate the advice but the system and appeal process is designed to be so complicated and time consuming that most people opt for alternatives just as surgery or opioids.

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How difficult can it be to go online and find your regional medicare administrator and write a letter? Administrators are listed on Medicare.gov. However, thinking can be more challenging than opiod use.

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I broke a ligament in the bottom of my foot in a yoga class after I moved to NY. It took 5 years and 5 doctors which were MDs and podiatrists until someone finally saw the fracture. I had surgery for repair but there is still a lump in the center of the bottom, metatarsal area. I cannot walk barefoot at all, my foot looks deformed but at least I can now walk without pain as long as I have the right shoes and an athletic store recommended a great pair of over the counter orthotics. Currex. They come in arch heights and some other measurements and I have 4 pair which I move around. I buy the high arch ones for runners. I do have high arches and the extra arch support takes the pressure off my metatarsal area. One doc recommended I wear Hoka One One Bondi shoes so I bought those also. I have found that the Bondi and the Clifton of that brand work really well for my foot and I have maybe 6 pair so I just don't even bother to wear anything else except in the freezing weather when I wear UGG boots that have removable insoles so that I can change the shearling inside or wash the insoles. - I wear them barefoot. The UGG womens boots with removable insoles are difficult to find, mine are old. I wear slippers with arch support as well or put shearling inside them. The insoles cost $49.95 and they also have them at zappos.com

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@lbroomayo1

I also use Medicare with a medicare supplement. I am a licensed insurance agent for 15 years and a RN Candidate in academic study. My suggestion is to appeal the Medicare ruling for not paying for the device. First you need a denial in writing from Medicare that the product is not covered. Then make a written appeal to your regional Medicare administrator, not a hospital or state entity. In the appeal, you need to explain the device and why it is needed in both clinical and lay terms. Your written appeal needs to address the issue in a point by point argumentative essay style format. I believe you can get the device. Best regards.

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In reply to @lbroomayo….that’s what I am doing regarding a medication. It is extremely frustrating to have to do this when last year it was covered at a tier 1 level and now it’s not covered at all and was denied. I also filed a consumer complaint with the attorney generals office of our state in addition to having my provider fill our an appeal,

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