How to Get the Most from Your Insurance for Orthotics Before Year-End

Every year, many Canadians lose hundreds of dollars in unused health benefits simply because they forget to use them before the year ends. If you’ve been thinking about getting new custom orthotics or orthopedic shoes, now is the perfect time to take action. Between October and December, most insurance plans reset, which means any remaining coverage for orthotics, orthopedic footwear, or compression therapy may disappear once the calendar flips to January.

It’s what we call the “use it or lose it” season, and it’s one of the busiest times of the year for clinics like ours.

Planning ahead not only helps you make the most of your coverage, but it also prevents those unexpected out-of-pocket costs that can catch you by surprise. By booking your assessment and getting your paperwork in order now, you’ll start the new year knowing you’ve made the most of your benefits.

Make the Most of Your Benefits Before Year-End

Most extended health plans in Canada renew every January 1st, which means any unclaimed coverage from this year doesn’t roll over.  For many people, that can mean missing out on hundreds of dollars’ worth of health support that’s already been set aside for your care.

When it comes to custom orthoticsandorthopedic shoes, the final months of the year are especially important. Cold weather, busy schedules, and more time spent indoors can all add stress to your feet and joints. It’s the season when many people begin to feel increased discomfort, stiffness, or swelling, exactly the kind of issues orthotics are designed to help with.

Using your benefits before they expire isn’t just a financial decision, it’s also a way to take proactive care of your health. Booking your fitting or assessment early helps you avoid last-minute holiday rushes and ensures your claim is processed before year-end.

Think of it as setting yourself up for success in the new year: more comfort, better mobility, and less pain, all while making the most of coverage you’ve already paid for through your plan.

How Insurance Works for Custom Orthotics and Medical Footwear

Before you schedule your fitting, it helps to know exactly what your insurance plan includes, and what it doesn’t. Coverage for custom orthotics and orthopedic shoes can vary depending on your provider, your plan type, and even your employer’s benefit policy.

In most cases, extended health plans will cover:

• Custom-made orthotics, designed specifically to fit your feet and correct your unique biomechanics.
• Orthopedic or medical-grade footwear, made to accommodate structural or medical conditions such as arthritis, plantar fasciitis, or diabetes.
• Assessments by certified professionals, such as a chiropodist or pedorthist, this step is often required to validate your claim.

Some plans may also extend coverage to compression therapy garments, ankle supports, or mobility aids, especially if they’re prescribed as part of a treatment plan.

If you’re unsure, it’s always worth calling your insurance provider or checking your benefits booklet. Ask questions like:

• “How much is covered for custom orthotics?”
• “Is a doctor’s prescription required?”
• “Can I claim both orthotics and orthopedic shoes in the same year?”

Knowing your exact coverage ahead of time helps you plan your appointments, purchases, and paperwork, and ensures there are no surprises when it’s time to submit your claim.

At Care-Med, we’re happy to help you review your insurance details before your appointment.

How to Claim Orthotics and Orthopedic Shoes

Filing an insurance claim for custom orthotics or orthopedic footwear doesn’t have to be complicated, but there are a few important steps to follow to make sure everything is approved quickly and smoothly. A little preparation goes a long way toward avoiding delays or denials.

1. Get a Prescription or Referral

Most insurance providers require a prescription from your doctor or specialist that states why you need orthotics or orthopedic shoes. This helps confirm medical necessity, a key part of most claims.

Tip: Ask your doctor to clearly include your diagnosis or symptoms (for example, plantar fasciitis, flat feet, or knee pain) on the prescription.

2. Book a Professional Assessment

Your orthotics or footwear must be professionally assessed and fitted by a licensed provider, such as a chiropodist, orthotist, or pedorthist. This ensures your devices are truly custom and meet insurance standards.

At Care-Med, our specialists perform detailed gait and pressure analyses to create orthotics that are uniquely designed for your comfort and mobility.

3. Keep All Itemized Receipts and Documentation

After your fitting or purchase, you’ll receive detailed receipts. Keep these safe, insurance companies often require:

• The provider’s registration number and credentials
• A breakdown showing the assessment fee, materials, and final orthotic or footwear cost
• The date of service and patient name

Organizing these documents early saves you from scrambling during the busy year-end season.

4. Submit Your Claim Promptly

Once you have your prescription, receipts, and assessment report, you’re ready to submit. Most providers allow online submission through their member portal, fast, paper-free, and trackable.
If you prefer mailing a physical claim, ensure all pages are included and clearly legible.

Submitting everything correctly the first time helps prevent processing delays and ensures you’re reimbursed as quickly as possible. And if you’re ever unsure, Care-Med’s team is happy to help you prepare your claim documents.

Common Claim Mistakes (and How to Avoid Them)

Even the best intentions can run into hiccups when it comes to insurance claims. Small oversights, like missing documents or unclear prescriptions, are some of the most common reasons claims for orthotics or orthopedic shoes get delayed or denied. The good news? Every one of them is easy to avoid with a little preparation.

Missing a Prescription or Assessment Report

Insurance companies almost always need proof of medical necessity. If you skip the doctor’s note or forget to include your chiropodist’s or pedorthist’s assessment report, your claim could be rejected.

Solution: Always include both a valid prescription and the professional assessment from your fitting appointment.

Buying Off-the-Shelf Instead of Custom-Made

Many people don’t realize that only custom-made orthotics, crafted from molds or digital scans of your feet, are eligible for insurance reimbursement. Over-the-counter inserts or comfort insoles may help temporarily, but they usually don’t qualify.

Solution: Confirm that your provider offers insurance-approved, custom-made orthotics and provides documentation to match.

Submitting After Your Benefit Year Ends

Timing matters! Submitting your claim after your benefit period expires (often December 31) may result in no reimbursement, even if your appointment was within the coverage year.

Solution: Book your appointment early enough to complete the fitting and claim submission before year-end, especially in November and December when clinics get busy.

Incomplete or Non-Itemized Receipts

A single lump-sum receipt doesn’t give insurers the details they need. They may request additional information, which delays reimbursement.

Solution: Ensure your receipts list all charges separately (assessment fee, orthotic fabrication, fitting, etc.) and include the provider’s registration details.

Not Verifying Coverage Before Purchase

Every insurance plan is different, some cover only orthotics, others include shoes or compression garments, too.

Solution: Take five minutes to call your insurer or check your benefits portal before your appointment. You’ll know exactly what to expect when you submit your claim.

If you’re ever uncertain, Care-Med’s team can walk you through the claim requirements step-by-step, ensuring nothing gets missed.

Making the Most of Your FSA or HSA

If your health plan includes a Flexible Spending Account (FSA) or Health Spending Account (HSA), you have even more opportunities to save, but only if you use those funds before they expire. These accounts are designed to help you cover medical expenses like custom orthotics, orthopedic shoes, compression garments, and other prescribed medical supports.

Unlike traditional insurance benefits, FSAs and some HSAs follow a simple rule: use it or lose it. Once the plan year ends, any remaining balance may disappear, and that’s money you’ve already set aside for your health.

How to Make the Most of It

1. Check your balance early. Log in to your provider’s portal or call your HR department to see how much you have left.
2. Plan your appointments now. Book fitting or assessment before the year-end rush so there’s enough time for production, delivery, and claim submission.
3. Bundle your health needs. If you’ve been meaning to replace older orthotics, invest in orthopedic footwear, or add compression socks, this is the ideal time to combine those expenses while you’re already claiming.
4. Keep your receipts organized. Whether you’re claiming directly or getting reimbursed through your FSA/HSA, clear, itemized receipts make everything faster and easier.

These accounts are a smart way to take control of your health spending. They help you save money by using pre-tax dollars for approved medical expenses, and that means lower out-of-pocket costs overall.

How to Prepare Your Receipts and Paperwork

Submitting a clean, complete claim is the easiest way to ensure your insurance provider reimburses you quickly and without extra back-and-forth. A little organization now can save you a lot of time later, especially during the busy year-end season.

Your Insurance-Ready Checklist

Before you submit your claim, make sure you have:

• A valid prescription or referral from your doctor, specifying the need for orthotics or orthopedic footwear.
• An itemized receipt showing each part of the purchase separately, assessment fee, materials, and device cost.
• The provider’s credentials and registration number. This proves your fitting was done by a certified professional, such as a chiropodist or pedorthist.
• A detailed assessment report, outlining your diagnosis or condition (for example: plantar fasciitis, pronation, or arthritis).
• The completed claim form, signed and dated.

Keep copies of everything, even digital versions. Most insurers now accept online submissions, which means you can upload PDFs or photos of your documents and track the status of your claim right from your account.

If you’re mailing your claim, double-check that all pages are included, clearly readable, and labeled with your name and policy number. A small detail like a missing page can delay your reimbursement.

Planning Ahead for 2026

Once you’ve made the most of your current benefits, it’s the perfect time to start planning for the year ahead. Many people don’t realize how much easier, and less stressful, the insurance process can be when you take a few simple steps early in the year.

Review Your Plan in January

When your new coverage year begins, take a few minutes to look over your policy or benefits booklet. Make note of:

• Your maximum coverage amount for orthotics, orthopedic shoes, and related services.
• Whether you’ll need a new doctor’s prescription this year.
• Any changes to your provider’s claim requirements or submission process.

Knowing this information early means no surprises later, and you’ll be able to schedule care when it’s most convenient for you.

Schedule Regular Check-Ups

Even the best orthotics can wear down over time. Most custom devices last about two to three years, depending on how often they’re used. Scheduling a mid-year or annual check-up ensures your orthotics still fit your needs and are supporting your body correctly.

Keep an Eye on Your FSAs and HSAs

If you have a spending account, plan your purchases throughout the year instead of saving them all for December. This helps you spread out costs and reduces the risk of missing your benefit deadline again.

Think Beyond Orthotics

Your coverage might include other helpful supports, compression therapy garments, braces, or orthopedic footwear that can enhance comfort and mobility. Using your benefits strategically throughout the year can make a big difference in your daily well-being.

Start the New Year on the Right Foot

Your health benefits exist for one purpose, to help you feel your best. Using them before they expire isn’t only about saving money; it’s an investment in comfort, mobility, and lasting well-being. Long hours on your feet, ongoing pain, or the desire to move with greater ease all point to the same solution: custom orthotics and orthopedic footwear can make a remarkable difference in how you feel every day.

As the year winds down, take this opportunity to put your benefits to good use. Schedule your fitting, organize your paperwork, and start 2026 knowing you’ve made the most of your coverage.  At Care-Med, our team is here to guide you every step of the way, from understanding your insurance coverage to ensuring your orthotics and orthopedic shoes are customized perfectly for your needs.