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Question/Topic
How does UMP cover orthotics?
Answer/Article

Important:  This information is effective through Dec. 31, 2009. See the changes for 2010.

When preauthorized by UMP and prescribed by an approved provider type, UMP covers only custom-fabricated or prefabricated (custom-fitted) foot orthotics as described below:

  • Shoes, if they are an integral part of a leg brace and its expense is included as part of the cost of the brace.

  • Rehabilitative foot orthotics prescribed as part of post-surgical or post-traumatic casting care.

  • Foot orthotics to compensate for a missing portion of the foot (amputation; congenital) or other lower extremity prosthesis used to restore function.

  • Orthotics (including extra-depth shoes with inserts or custom-molded shoes with inserts) used for patients with impaired peripheral sensation or altered peripheral circulation (for example, diabetic neuropathy and peripheral vascular disease).

  • Orthotics for patients with neurological or neuromuscular conditions producing spasticity, misalignment, or pathological positioning of the foot where there is reasonable expectation of improvement.

See exclusion 45 in the 2009 Expenses Not Covered, Exclusions, and Limitations.


Related Items
How do I request preauthorization of services?
KBID 853
Date Modified 10/5/2009
Date Created 10/8/2008

The Certificate of Coverage (COC) is the source of coverage provisions offered under UMP. If information given here is inconsistent with the UMP COC, the rules in the COC will apply. Also, the COC may have additional information on this subject.

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