Reimbursement for medical foot care

Medical foot care is intended for people with a diagnosed increased risk of foot ulcers. Whether you are eligible for reimbursement under the basic health insurance depends on your situation. First, it must be determined whether you are at an increased risk of foot ulcers. This risk may arise from diabetes, another chronic condition or medical treatment that affects the health of your feet.

• This concerns medically necessary foot care;
• there is a confirmed increased risk of foot wounds;
• the podiatrist has drawn up a care profile and treatment plan.

The podiatrist assesses what care is needed to prevent foot wounds. The treatment plan sets out which foot care is appropriate for your situation.

Please note: reimbursement depends on your circumstances and the terms and conditions of your health insurer. You should therefore always check your policy or contact your health insurer.

The podiatrist assesses whether there is an increased risk of foot ulcers. This is done as follows:

The podiatrist will examine your feet and assess your health and medical history. This helps to determine whether you are at increased risk of foot ulcers and what care is needed to prevent problems.

Among other things, the podiatrist looks at:

• whether there are any pressure points, calluses, sores or deformities;
• or if you have reduced sensation in your feet;
• or whether your blood flow has decreased;
• or if you have previously had a foot injury;
• or whether there are other medical factors affecting your feet.

Based on this assessment, the podiatrist determines which foot care is medically necessary. They will also determine whether you are eligible for medical foot care covered by your basic health insurance.

Has the podiatrist determined that you are eligible for medical foot care? If so, the podiatrist will then draw up your care profile.

Care profiles range from profile 1 to profile 4 inclusive. The care profile helps to determine:

• what care is needed;
• how often treatment or a check-up is required;
• which reimbursement applies.

The following applies:

• Care Profile 1: foot care is not covered by basic health insurance. You may be eligible for reimbursement under a supplementary insurance;
• Care profile 2, 3 or 4: treatments included in your podiatry treatment plan are reimbursed under the basic health insurance.

Your personal treatment plan sets out the foot care you require. The podiatrist draws up this treatment plan based on the assessment and your personal circumstances.

The treatment plan states, amongst other things:

• what medically necessary foot care you require;
• which healthcare professionals are involved in your treatment;
• which care is covered by basic health insurance.

Only medically necessary foot care included in your treatment plan is covered by basic health insurance. You will not receive an invoice for the care that is covered under your treatment plan.