How Much Do Orthotics Cost?

Orthotics are corrective devices to help individuals with foot conditions such as flat feet or plantar fasciitis. While Orthotics are helpful for alleviating pain, they can also be quite expensive and are more often than not in the USA not covered by most insurance.

Orthotics have a wide range in prices depending on what materials are used, which provider you see, and what condition he/she is treating for. Let’s break things down to help you make an informed decision on what orthotic to buy.

What are Custom Orthotics

Custom Orthotics are custom designed inserts usually prescribed by a podiatrist or other medical professional. The difference between custom orthotics and OTC over the counter orthotics are that they are custom made to an individuals foot, condition, gait, activity, and any other thing the doctor deems necessary. They generally work by redistributing pressure across the feet, providing targeted relief to common foot conditions. Orthotics are also valuable to helping to prevent future injuries and improve posture. 

Who Needs Custom Orthotics

Custom orthotics are valuable for those with the following conditions

• Plantar Fasciitis - heel pain caused by an inflammation of the plantar fascia
• Flat Feet - arch pain caused by a lack of a arch, often associated with over pronation
• Bunions - an alignment of joints where the big toe starts to curve inwards
• Heel Spurs - a calcium deposit in the heel region caused by continued pressure. 
• High Arches - An arch that doesn’t splay when you step down and often associated with heel/ball of foot pain which bears the brunt of the pain

Custom Orthotics vs Over-the-counter Orthotics

Although OTC are generally more affordable, they are not personalized, and thus don’t achieve the same level of relief. Some points unique to custom orthotics

• They are molded to your foot, generally through a physical mold being used or a 3D scan of your foot
• Address an exact biomechanical issue, not just general foot pain
• Last longer through usage of higher quality materials. 

Costs of Custom Orthotics

Generally, custom orthotics bought from a podiatrist, chiropractor or other medical professional can run anywhere from $400-$800 but that number can vary wildly. 

The way the industry works is a podiatrist actually outsources the orthotic production to a 3rd party manufacturer which makes the orthotic. The podiatrist gets charged anywhere from $80-$140 for the production of the orthotic. The price you end up paying is based on the doctor’s markup on top of that production cost. The doctor can thus charge you whatever he/she wants. Generally some principles apply:

Factors that impact Price

Where you live

You will pay more if you live in a wealthy area. A podiatrist in an affluent area knows he can charge more money as there is a willingness to pay. For example, you may be charged upwards of $1200 if you want to get a pair of orthotics in The Upper West Side - New York City. However, if you go to a place like outer Queens, expect to pay closer to $300. 

If you see a doctor in person

You will pay more if you visit a doctor in person. In person visits cost the doctor time to rent out office space, pay receptionists, deal with cancellations, etc… for that, the doctor is required to mark up the cost versus the actual cost of the orthotic. For this reason you can expect to pay more in person versus online orthotics. Stride Soles offers a much more reasonable alternative if you are looking to buy a pair. 

If you are getting a new orthotic, or just a remake

If you have an existing orthotic, and you just want the same pair remade, you can talk to your doctor and potentially work out a deal to just have the exact same one reproduced. The doctor should be able to just copy what was already done, although many doctors will not agree to this request as they won’t make as much. Call ahead to see if this is possible. 

If you see a podiatrist versus Chiropractor versus Physical Therapist

This is a generalization, but generally you will pay less getting orthotics from a Physical Therapist. The reason is that orthotics are generally not a major part of their business so they don’t really see if as a ‘money maker’ worth marking up. 

How to pay less for custom Orthotics

1: Call Ahead 

If you know you are going to need custom orthotics, call around your vicinity. Consider going to see doctors in poorer areas where the majority of the population is on government assistance. You should be able to find a doctor charging less than $300 if you are able to look around

2: Get a prescription then shop around

You can see your top Podiatrist to get the prescription, which is basically the list of ‘corrections’ that need to be made so your orthotic fits your individual condition. Once you have the prescription, call up other providers to see who offers the cheapest orthotic. For example, once you get your prescription, you can have Stride Soles make your orthotic for $98. 

3: Work with the manufacturers directly

While not common, it’s not impossible to reach out to a orthotics manufacturer and see if they will make a one-off pair for you. You’d need your prescription, but by scanning your foot and getting a .STL file, a manufacturer would be able to help you out. You can contact Langer clinic, for example. 

4: Use your FSA/HSA card

Custom Orthotics like Stride Soles can be paid for with your FSA/HSA card. FSA/HSA is a tax advantaged account which should be leveraged be all individuals. Any orthotic purchased at a podiatry clinic should be covered as well. 

5: Go to Europe

If you are in Europe, consider getting a pair of orthotics there. Even without insurance, you can expect to pay in the $200 range on the top end. Places like Germany and France are well known for their orthotics (Stride Soles is made in Germany for this reason), and produce orthotics which are far beyond what is made in the USA. 

Are Custom Orthotics Covered By Insurance

The best way to pay less for custom orthotics are to get them covered by insurance. The question is are they? Well it depends… 

Most insurance companies will only pay for orthotics if they are deemed absolutely necessary because of your condition. Even if your podiatrist gives you a referral, there is no guarantee that they will be covered. To increase the chances of getting your orthotics approved, be sure to document your condition and what you’ve tried that didn’t work before. For example, if you have plantar fasciitis, tell your doctor about stretches and OTC insoles which haven’t worked. 

If you are unsure if you will get orthotics covered call your insurance company directly and try to get pre-authorization. Your Podiatrist/Chiropractor should have an idea if they will be covered or not. 

Medicare and Orthotics

Medicare will only pay if it’s deemed medically necessary. This is notoriously difficult though to get basic conditions to qualify, and unless you have something like Diabetes or Sesamoiditis, it will be quite difficult. If you do get it approved, however, you can get 80% of the cost covered under Part B

Conclusion

Custom Orthotics are surely not cheap medical devices. However, they are effective to combat pain associated with the most common conditions. We encourage you to shop around and see what options are available to you.