You may be eligible for shoes – at no cost to you! Enter your information in the form below to find out if you qualify for shoe coverage. Medicare or your insurance provider may cover the cost of one pair of shoes and three pairs of custom or heat molded insoles per calendar year. Find out if you qualify now!

Besides Medicare, here is a list of private insurance providers: AARP United Health Care, Aetna, Anthem BCBS, ChampVA, Coventry, Empire BCBS, Humana, Blue Cross Blue Shield, Care Improvement, Pyramid, Secure Horizons, United Health Care,  Tricare, Wellcare.  Any many more.

    Personal Information

    Medicare And Insurance Information

    Is Medicare Your Primary Insurance?


    Supplementary / Secondary Insurance Information

    Primary Physician Information (M.D Or D.O Only No Podiatrist Please)

    Medicare Covered Products (Check Next To Each Product You Want To Receive)

    Tens UnitAnkle BraceSeat LiftKnee BraceBack BraceWrist Brace

    Confirm & Submit Application

    Additional Comments

    By submitting this information, I authorize The Diabetic Shoppe Inc., its affiliates, subsidiaries, or parent company to contact me by phone or email. Please be assured that we value and protect your privacy. Remember, there is no purchase necessary to see if you qualify.