Does Medicare Cover Toenail Clipping Services at an Assisted Living Facility?

Medicare typically doesn’t cover toenail clipping and other routine foot care services at an assisted living facility. This federal benefits program only pays for medical needs, not for help with activities of daily living, such as grooming. Routine foot care services include clipping, cutting, trimming and debriding toenails as well as removing or cutting corns and calluses.

Medicare has exceptions to this rule. Your benefits may pay for toenail clipping if it’s medically necessary. For example, you might have a toenail infection or a systemic condition that requires toenail clipping for treatment. Medicare also pays for toenail clipping if it occurs as a necessary part of another covered service.

These exceptions apply whether you reside at an assisted living facility, at home or in another care setting. In this case, your health care provider should document the medical need for professional toenail clipping services when you submit your Medicare claim.

Many older adults develop diabetes, which can lead to serious health complications, including nerve damage to the feet. If this occurs, you could develop a severe infection from a minor cut or blister. For this reason, people who have diabetes should have regular foot inspections by a podiatrist. They should also get help cutting their toenails carefully from an assisted living staff member, health care provider or caregiver.