Ingrown toenails are a common foot problem that occurs when the nail grows into the surrounding skin. This can cause pain, swelling, and even infection. If left untreated, an ingrown toenail can become a chronic problem. For people with Medicare, it is important to understand whether Medicare covers ingrown toenail removal and what kind of doctor can perform the procedure.
Is Ingrown Toenail Removal Considered Routine Foot Care?
Routine foot care is the regular maintenance of healthy feet, such as nail trimming and callus removal. Medicare covers routine foot care for people with certain medical conditions, such as diabetes or nerve damage. However, ingrown toenail removal is not typically considered routine foot care.
According to the Centers for Medicare & Medicaid Services (CMS), Medicare only covers foot care services that are “medically necessary.” Medically necessary foot care services are those that are required to treat a specific medical condition. In the case of an ingrown toenail, if it is causing pain, swelling, or infection, it may be considered medically necessary.
What Kind Of Doctor Removes Ingrown Toenails?
Several healthcare professionals can remove an ingrown toenail, including podiatrists, dermatologists, and general practitioners.
A podiatrist is a foot and ankle specialist who has completed four years of podiatric medical school and a three-year residency. Podiatrists are specifically trained to diagnose and treat foot and ankle problems, including ingrown toenails. They can perform both non-surgical and surgical treatments for ingrown toenails.
A dermatologist is a medical doctor who specializes in the diagnosis and treatment of skin, hair, and nail conditions. They are not trained specifically in foot and ankle problems, but they can perform ingrown toenail removal if necessary.
A general practitioner is a medical doctor who provides primary care services, including treating common foot problems such as ingrown toenails. However, they may refer patients to a specialist if the problem is complex.
When choosing a doctor to remove an ingrown toenail, it is important to consider their training and experience in treating foot problems. Patients with Medicare should ensure that the doctor they choose accepts Medicare assignment.
Medicare Coverage For Ingrown Toenail Removal
Medicare Part B covers medically necessary foot care services, including ingrown toenail removal. However, there are specific criteria that must be met for Medicare to cover the procedure.
First, the ingrown toenail must be causing pain, infection, or another medical problem. Second, the procedure must be performed by a healthcare professional who is legally allowed to do so in their state. Finally, the procedure must be performed in a healthcare setting, such as a doctor’s office or outpatient clinic.
If Medicare covers the ingrown toenail removal, the patient is responsible for the Part B deductible, which is $203 in 2023. After the deductible is met, Medicare typically covers 80% of the approved amount, and the patient is responsible for the remaining 20%.
Alternatives To Ingrown Toenail Removal
In some cases, non-surgical treatments may be effective for treating ingrown toenails. Soaking the foot in warm water, applying antibiotic ointment, and using a sterile instrument to gently lift the nail may help relieve the symptoms. However, if the ingrown toenail is causing significant pain or infection, surgical removal may be necessary.
If non-surgical treatments are recommended, Medicare may cover them if they are medically necessary. Patients should talk to their healthcare provider and Medicare representative to determine their coverage.
Conclusion
Ingrown toenails can be a painful and uncomfortable problem, but with proper treatment, they can be resolved. For people with Medicare, it is important to understand Medicare coverage for ingrown toenail removal and to choose a qualified healthcare professional to perform the procedure.
Contact The Mair Agency Today
If you want to learn more about Medicare and what procedures are covered under your current plan, contact the experts at The Mair Agency today! Our knowledgeable staff will get you the information you need regarding plan coverage and any additional question you may have!
Resources:
Centers for Medicare & Medicaid Services (CMS). (2021). Medicare Coverage of Foot Care Services. Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Foot-Care-Services-Fact-Sheet-ICN909234.pdf
American Podiatric Medical Association. (2021). Ingrown Toenail. Retrieved from https://www.apma.org/conditions/ingrown-toenail
American Academy of Dermatology Association. (2021). Ingrown Toenail. Retrieved from https://www.aad.org/public/diseases/other-conditions/ingrown-toenail