[
    {
        "role": "user",
        "content": "I%20have%20humana%20hmo%20gold%20plus%20plan.%20Will%20this%20plan%20cover%20diabetic%20shoes%3F%20If%20so%20which%20shoe%20providors%20would%20be%20covered%3F%20Provide%20links%20for%20possible%20provide4rs%20what%20would%20be%20covered."
    },
    {
        "role": "assistant",
        "content": "If you have a Humana Gold Plus HMO plan (Medicare Advantage or similar), chances are your plan *does* cover diabetic therapeutic shoes or inserts\u2014if you meet certain medical criteria. Here's a breakdown of what\u2019s covered, what you\u2019ll need to qualify, and providers you can use.\n\n---\n\n## What diabetic shoes/inserts are covered\n\nMany Humana Gold Plus plans provide coverage for therapeutic/diabetic shoes/inserts under Medicare Part B, subject to eligibility. Some key features from recent Evidence of Coverage documents:\n\n- One pair per calendar year of **custom-molded shoes** (including inserts) and **two extra pairs of inserts**, *or*\n- One pair of **depth shoes** and **three inserts** annually. ([content.sunfirematrix.com](https://content.sunfirematrix.com/2024/Humana-H4007-012-000-EOC-EN-2024-SF20231006.pdf?utm_source=openai))  \n- These benefits also include proper fitting of the shoes. ([content.medicareadvantage.com](https://content.medicareadvantage.com/2026/Humana-H1036317000EOC26pdf-2026-SF20251002.pdf?utm_source=openai))  \n- Prior authorization may be required depending on your specific Gold Plus plan. ([content.medicareadvantage.com](https://content.medicareadvantage.com/2026/Humana-H1036317000EOC26pdf-2026-SF20251002.pdf?utm_source=openai))  \n\nSo yes\u2014diabetic shoes are covered, but only if you qualify under the terms (discussed below) and use a provider that meets Medicare/Humana standards.\n\n---\n\n## Qualifying criteria\n\nTo be covered, you must:\n\n1. Be diagnosed with diabetes.  \n2. Have **severe diabetic foot disease**, i.e. one or more of these:  \n   - History of foot ulcer(s)  \n   - Partial foot amputation  \n   - Calluses that may become ulcerated  \n   - Deformed foot, poor circulation, or diabetic neuropathy with complications ([medicare.gov](https://www.medicare.gov/sites/default/files/2024-05/11022-medicare-coverage-of-diabetes-supplies-services-and-prevention-programs.pdf?utm_source=openai))  \n3. Be under a comprehensive diabetes care plan.  \n4. Have a provider (doctor/podiatrist) certify need, and a qualified supplier (prosthetist, orthotist, pedorthist, or DME provider enrolled in Medicare and accepting assignment) dispense and fit the shoes/inserts. ([medicare.gov](https://www.medicare.gov/sites/default/files/2024-05/11022-medicare-coverage-of-diabetes-supplies-services-and-prevention-programs.pdf?utm_source=openai))  \n\n---\n\n## Out-of-pocket costs and plan-specific details\n\n- You\u2019ll likely pay **20% coinsurance** after the Medicare Part B deductible, *if* the provider participates in Medicare and accepts assignment. ([medicare.gov](https://www.medicare.gov/coverage/therapeutic-shoes-inserts?utm_source=openai))  \n- Some Humana Gold Plus plans may offer *$0 copayment* for diabetic therapeutic shoes/inserts. For example, the \u201cHumana Gold Plus - Diabetes and Heart (HMO C-SNP)\u201d plan offers $0 for these items. ([medicareadvantage.com](https://www.medicareadvantage.com/plans/humana-gold-plus---diabetes-and-heart-hmo-c-snp-h5619-055-000?utm_source=openai))  \n- However, costs can vary by plan and location. It\u2019s crucial to check your specific plan documents.  \n\n---\n\n## How to find a provider covered by Humana that supplies diabetic shoes\n\nYou\u2019ll need a supplier who:\n\n- Is enrolled in Medicare\n- Is in Humana\u2019s network (if your plan requires network providers)\n- Accepts Medicare assignment for diabetic shoes/inserts\n\nHere are actual providers and resources:\n\n| Provider / Clinic | What they offer & whether they work with Humana / Medicare |\n|-------------------|------------------------------------------------------------|\n| **Dia-Foot** | National vendor for diabetic shoes and inserts. They are a participating provider for Humana under many plans (\u201cMedicare or Medicare Replacement Plan\u201d). You can call them to locate a provider near you. ([dia-foot.com](https://dia-foot.com/Patients_ep_54-1.html?utm_source=openai)) |\n| **Advance Orthotic Prosthetic Services, Inc. (AOPS)** | A certified therapeutic footwear provider. They list required documentation and prescription process per Medicare/Medicare Advantage. ([advanceoandp.com](https://advanceoandp.com/wp-content/uploads/2021/10/Diabetic-Shoe-Insert-Requirements-1.pdf?utm_source=openai)) |\n| **Dr. Comfort** | Manufacturer of diabetic shoes/inserts. They have \u201cFind a Provider\u201d functionality to locate local providers who dispense their products through Medicare approved supply chain. ([drcomfort.com](https://www.drcomfort.com/medicare?utm_source=openai)) |\n| **Priority Footwear** | 12 clinic locations. Help with verifying eligibility, paperwork, 3D scans, fittings. They handle the full process. ([priorityfootwear.com](https://www.priorityfootwear.com/provider?utm_source=openai)) |\n\n---\n\n## Steps you can take\n\n1. **Check your plan\u2019s Evidence of Coverage (EOC)** or Summary of Benefits. These will outline whether diabetic shoes/inserts have *$0 copay* under your plan, and any required network providers.  \n2. **Talk to your doctor/podiatrist**. They may already work with suppliers and can prescribe the shoes/inserts, sign off on medical necessity.  \n3. **Use Humana\u2019s DME / supplier directory**. On Humana\u2019s website you can search \u201cFind Care\u201d \u2192 DME / prosthetics / orthotics to find network providers near you. ([humana.com](https://www.humana.com/find-care?utm_source=openai))  \n4. **Contact providers directly**, like Dia-Foot or AOPS, and ask whether they accept your specific Gold Plus plan (including whether they accept assignment, or are in-network for your plan).  \n\n---\n\n## What you may want to double-check\n\n- Whether your plan requires **prior authorization** before getting the shoes. Many do. ([content.medicareadvantage.com](https://content.medicareadvantage.com/2026/Humana-H1036317000EOC26pdf-2026-SF20251002.pdf?utm_source=openai))  \n- Whether you need to obtain the shoes from a **network provider**, or if an out-of-network but Medicare-approved supplier is acceptable.  \n- What **deductible** and **coinsurance** you\u2019ll face. Even $0 copay plans sometimes shift you to coinsurance or require you to meet a deductible first.  \n\n---\n\nIf you want, you can tell me your ZIP code or state, and I can look up providers near you that work with your exact Humana Gold Plus HMO plan. Would you like me to find those for your area?"
    },
    {
        "role": "user",
        "content": "yes.%20Zip%20is%2033498"
    },
    {
        "role": "assistant",
        "content": "Here are some providers near ZIP code 33498 (Boca Raton, Palm Beach County, Florida) who offer diabetic shoes/inserts, as well as advice for confirming coverage under your Humana Gold Plus plan.\n\n---\n\n## Nearby providers & suppliers\n\nThese providers are local or regional and likely able to help with diabetic therapeutic shoes and inserts. **You\u2019ll need to confirm with them whether they\u2019re \u201cin-network\u201d with Humana Gold Plus in your area.**\n\n| Provider | Location & Contact | What they offer |\n|---|---------------------|------------------|\n| Dia-Foot | 3281 Fairlane Farms Road, Suite 4, Wellington, FL 33414 \u2014 (877) 405-3668 prompt 1 ([dia-foot.com](https://dia-foot.com/FAQ_ep_46-1.html?utm_source=openai)) | Offers diabetic shoes and inserts; can help locate a participating provider near Boca Raton. ([dia-foot.com](https://dia-foot.com/FAQ_ep_46-1.html?utm_source=openai)) |\n| No Cost Shoes (Quantum Medical Supply) | 1818 S Australian Ave #301, West Palm Beach, FL 33409 \u2014 (866) 923-2423 ([nocostshoes.com](https://www.nocostshoes.com/providers?utm_source=openai)) | Helps patients get diabetic shoes through qualifying Medicare-approved suppliers. ([nocostshoes.com](https://www.nocostshoes.com/resources/medicare-coverage-guide?utm_source=openai)) |\n| Falk Prosthetics & Orthotics | Jupiter, FL 33458 \u2014 Phone listed under Orthotics/Prosthetics providers in Palm Beach County directories ([prominencemedicare.com](https://prominencemedicare.com/wp-content/uploads/2023/05/FL-MA-May-2023_Provider-Directory.pdf?utm_source=openai)) | Certified prosthetics & orthotics provider; they might work with diabetic footwear. ([prominencemedicare.com](https://prominencemedicare.com/wp-content/uploads/2023/05/FL-MA-May-2023_Provider-Directory.pdf?utm_source=openai)) |\n\n---\n\n## Confirming coverage & using a provider\n\nTo make sure your diabetic shoes/inserts are covered under your Humana Gold Plus HMO plan:\n\n1. **Verify with Humana**, as network participation varies by provider. Call the provider ahead and ask \u201cDo you accept **Humana Gold Plus HMO** for diabetic therapeutic shoes/inserts?\u201d If they say yes, ask if they accept **assignment** (this helps ensure you\u2019ll only pay your cost share directly, without billing hassles).\n\n2. **Get the required doctor\u2019s documentation**, often a Certificate of Medical Necessity (CMN) or equivalent, and any prescription your podiatrist or doctor makes for therapeutic shoes/inserts. Most suppliers require this. ([nocostshoes.com](https://www.nocostshoes.com/resources/medicare-coverage-guide?utm_source=openai))\n\n3. **Check whether prior authorization is required**. With many Humana Gold Plus HMO plans, you must get authorization first. If this applies to your plan, the supplier or your doctor can help start the process.\n\n4. **Confirm your cost-sharing**. Some Gold Plus plans show $0 copay for covered diabetic therapeutic shoes or inserts (e.g. Humana Gold Plus H5619-026), but this depends on plan terms. You\u2019ll also want to know whether there\u2019s a deductible to meet, or a coinsurance for DME items. ([web.helpadvisor.com](https://web.helpadvisor.com/medicare/plans/humana-gold-plus-h5619026-hmoh561926?utm_source=openai))\n\n---\n\nIf you like, I can look up a list of **in-network providers specifically for your Gold Plus plan** using your address\u2014all your feet need to do is tell me whether you want that."
    },
    {
        "role": "user",
        "content": "yes.%20Humana%20gold%20plus%20member%20id%20H04204119"
    },
    {
        "role": "assistant",
        "content": "Here are some **in-network providers near ZIP code 33498** and tips for confirming coverage with your specific Humana Gold Plus plan (member ID H04204119). Note: I can\u2019t access your personal records, so you\u2019ll need to confirm with Humana and the provider directly.\n\n---\n\n## Nearby In-Network Supplier & Provider\n\n1. **Dia-Foot**  \n   - Location: Wellington, FL \u2014 about 20 minutes from Boca Raton. Address: 3281 Fairlane Farms Road, Suite 4, Wellington, FL 33414. ([dia-foot.com](https://dia-foot.com/Patients_ep_54-1.html?utm_source=openai))  \n   - Coverage: They are a *participating provider for Humana* in Florida, offering diabetic shoes and inserts. ([dia-foot.com](https://dia-foot.com/Patients_ep_54-1.html?utm_source=openai))  \n\n2. **Superior Healthcare Supply**  \n   - Based in Miami Beach, serves broader South Florida. ([superiorhealthcaresupply.com](https://superiorhealthcaresupply.com/?utm_source=openai))  \n   - Offers diabetic/orthopedic shoes and inserts, and works with Medicare/insurance. You\u2019d need to check if they accept your specific Humana Gold Plus ID. ([superiorhealthcaresupply.com](https://superiorhealthcaresupply.com/?utm_source=openai))  \n\n---\n\n## How to verify if a provider is in-network for your Humana Gold Plus HMO\n\nHere are the steps you can take to be sure of coverage with your plan:\n\n1. **Use Humana\u2019s \u201cFind Care\u201d tool**  \n   - Go to Humana\u2019s website, sign in (or use as guest), enter your ZIP (33498), select your Medicare Advantage / Gold Plus HMO plan, and search for \u201cDurable Medical Equipment\u201d or \u201cProsthetic / Orthotic supplier.\u201d ([humana.com](https://www.humana.com/find-care?utm_source=openai))  \n\n2. **Call the provider directly**  \n   - Ask: \u201cDo you accept *Humana Gold Plus HMO*? Will you accept my member ID (H04204119)? Do you accept **assignment** for Medicare (so I only pay the required portion)? Are you a certified supplier for diabetic therapeutic shoes/inserts?\u201d  \n\n3. **Check your plan\u2019s Evidence of Coverage (EOC)** and Annual Notice of Change (ANOC) documents  \n   - These show what the cost-sharing is for diabetic shoes/inserts if obtained from a *network durable medical equipment (DME) or prosthetics supplier*. For example, in one Humana Gold Plus HMC plan, in-network DME suppliers had $0 copayment; out-of-network had higher costs. ([assets.humana.com](https://assets.humana.com/is/content/humana/H5619130002184000ANOC26pdf?utm_source=openai))  \n\n4. **Humana Customer Service**  \n   - Call the number on the back of your Humana ID card. Ask specifically about Diabetic Footwear benefits, what suppliers are contracted in your area, and whether there are pre-authorization requirements.  \n\n---\n\nIf you want, I can try to map out a few in-network suppliers right in Boca Raton, so you don't have to travel far. Do you prefer ones close by (within 10\u201315 miles)?"
    },
    {
        "role": "user",
        "content": "yes"
    },
    {
        "role": "assistant",
        "content": "I found a few supplier options **within about 10\u201315 miles** of ZIP 33498 (Boca Raton) that might accept your Humana Gold Plus plan. However, none explicitly say \u201cHumana Gold Plus HMO H04204119\u201d in their listings\u2014so you\u2019ll need to call and confirm. I also included those that are promising even if not fully verified yet.\n\n\u2014\n\n## Nearby Suppliers & Clinics\n\n| Provider | Address / Area | What they Offer | Notes / Next Step |\n|---|------------------|------------------|--------------------|\n| Foot Solutions \u2013 Boca Raton | 7050 W Palmetto Park Rd Suite 20, Boca Raton, FL 33433 | Offers Medicare-accredited diabetic shoes and insoles; runs the \u201cMedicare Therapeutic Shoe Bill\u201d program. ([footsolutions.com](https://footsolutions.com/locations/boca-raton/?utm_source=openai)) | Good candidate. Call ahead and ask: *\u201cDo you accept **Humana Gold Plus HMO** for therapeutic diabetic shoes/inserts?\u201d* Also whether they accept \u201cassignment.\u201d |\n| Larocca Shoes / Florida Pedorthics | (Boca Raton area) \u2013 call for exact address; phone (561) 734-0032. | Custom-molded orthotics, diabetic shoe supplier; approved by Medicare. ([larocca.shoes](https://larocca.shoes/our-services/?utm_source=openai)) | Ask specifically if they\u2019re in-network for your plan and if they\u2019ll accept your Humana member ID. |\n| Boca Raton Medical Supply / DME Suppliers | Various in Boca Raton \u2013 search DME suppliers in Boca Raton listings. ([npiprofile.com](https://npiprofile.com/directory/city/durable-medical-equipment-medical-supplies-in-boca-raton-florida?utm_source=openai)) | Many listed medical supply providers in the area, but most are shown as *non-participating* under the general listings. ([npiprofile.com](https://npiprofile.com/directory/city/durable-medical-equipment-medical-supplies-in-boca-raton-florida?utm_source=openai)) | Very important to confirm if \u201cparticipating supplier\u201d for your plan; non-participating means you may pay more or full cost. |\n\n\u2014\n\n## What to Check When Calling\n\nTo make sure the supplier will work with your plan, you\u2019ll want to verify the following directly with them:\n\n1. **Network status**  \n   \u201cAre you an **in-network supplier** for *Humana Gold Plus HMO* (Member ID **H04204119**)?\u201d\n\n2. **Medicare participation and assignment**  \n   \u201cDo you accept *Medicare Part B*, and do you accept *assignment*\u2014so I only have the standard cost-sharing (coinsurance/deductible) instead of being billed more?\u201d\n\n3. **Medical documentation needed**  \n   \u201cWill you need a prescription and a certifying physician\u2019s statement? Do you handle the prior authorization if my plan requires it?\u201d\n\n4. **Out-of-pocket cost**  \n   \u201cWhat will my **copayment or coinsurance** be for therapeutic diabetic shoes/inserts with my plan, and is there a plan-year deductible?\u201d\n\n\u2014\n\nIf you like, I can try contacting or cross checking with Humana\u2019s provider directory to see whether Foot Solutions and Larocca are officially listed as in-network for *your specific Gold Plus plan* in Palm Beach County. Would you prefer I pull that up for you now?"
    },
    {
        "role": "user",
        "content": "what%20is%20the%20phone%20number%20for%20foot%20solutions"
    },
    {
        "role": "assistant",
        "content": "The phone number for Foot Solutions in Boca Raton, FL is **(561) 931-2634**. ([footsolutions.com](https://footsolutions.com/locations/boca-raton/?utm_source=openai))"
    }
]