Payment
Medicare generally does not cover routine foot care. However, foot care services may be billed to Medicare if you are actively treated by a doctor for a medical condition affecting circulation of the legs or feet.
Medicare Part B covers the services of a podiatrist (foot doctor) for medically necessary treatment of injuries or diseases of the foot (such as hammer toe, bunion deformities and heel spurs).
The majority of people we see do not have conditions that warrant Medicare coverage. If Medicare might cover foot care, our nurses would recommend you see a Podiatrist who bills Medicare. Some people pay a deductible to their Podiatrist which is higher than our base price. We recommend you shop around and get the best price.
Because Medicare pays for so few people to have foot care, we have opted to keep our costs down and not bill Medicare. This eliminates the added expense of paying someone to manage our insurance billing and collections and keeps our overall price as low as possible.
The recommended length between trims is between 8 to 10 weeks. Most people use a two month interval. It really depends on how fast your nails grow. We try to determine the interval between visits based on individual needs.
Our mission is to provide safe, cost effective foot and toenail care in accessible locations. This mission drives our cost. Our cost is low and reasonable because we generally provide clinics in locations which do not charge us for the use of their room. However, some locations charge us a small fee in order to cover their utility costs. We accept cash or checks made out to Toe Nail Trimmers.
Thick/Fungal Nails
Thickened and discolored nails may be caused by a fungus which grows under the nails called “onychomycosis”. It accounts for half of all nail disorders.
Fungus likes an environment that is warm, moist, and dark. Also, a trauma to the nail (tight fitting shoes, chronic stubbing or dropping something heavy on the toe) can make the nail more susceptible to fungal growth.
Fungus is difficult to treat and has a large incidence of recurrence. Treatments are either expensive or time consuming. Check our Resources page for further information. See your doctor for specifics. No matter what the treatment, you must eliminate the environment that fungal nails enjoy. This means keeping feet cool, dry and exposed to the light. Drying the feet with a cool hair dryer after a bath and alternating between 2 pair of shoes go a long way to keeping feet dry and uninviting to fungus.
At this point it is too early to say if nail fungus laser treatment is worth the price. The Treatment can be expensive. Nail fungus laser treatment costs between $1,000 and $2,500. The laser onychomycosis treatment is not covered by health insurance since onychomycosis is viewed as a cosmetic disease (which is more or less correct, barring complications or severe disease). Therefore the cost of laser nail fungus treatment must be covered in full by the patient. Laser treatment for fungal nails has a 50% recurrence rate.
Over the counter topical treatments for nail fungus are preferred by people with contraindications to taking therapy by mouth, such as liver disease. Topicals may be used when the infection is mild. Topicals are generally NOT able to cure fungus alone because of inadequate penetration into/under the nail. Topicals are not curative but may be used to contain the infection and prevent spread. These must generally be applied daily for a year or twice a day for 6 months. It is always best to check with your doctor before trying any treatment.
Oral drugs (by mouth) are more effective and convenient than topical treatments but have more side effects, drug interactions and are more costly. Oral therapy is preferred over topical agents in people with painful nails, significant nail involvement, diabetes or immunodeficiency and other treatments have failed. The failure rate is approximately 50%. Check with your doctor if you are interested in prescription oral therapy.
We use an electric nail file that thins down thickened nails. Thinning the nail gives the nail a better appearance, makes shoes fit better and can allow for better penetration of topical treatments.
Ingrown Nails
Some common causes of an ingrown toenail include cutting the nails too short or not straight across, injury to the toenail, and wearing shoes that crowd the toenails.
The American Academy of Orthopaedic Surgeons Foot and Ankle Society recommends nails should be cut straight across with a clean, sharp nail trimmer without tapering or rounding the corners. Trim the nails no shorter than the edge of the toe. For further information on ingrown nails go to: orthoinfo.aaos.org
Nursing Care
Customer safety is of utmost importance. Every client receives a full medical assessment on their first visit and annually thereafter. If a client goes to a different location, they may receive another assessment since they would not have a record at the second location. Our policy is to maintain a record at each clinic the client frequents. Therefore, if you go to several clinics, you may experience an assessment multiple times. This policy assures that each nurse is familiar with their client’s medical history and is giving care based on the needs of the individual client.
We do a medical assessment, trim nails, smooth calluses and help deal with medical problems of the feet. We do not provide a foot soak or spa-type treatments. Our nurses have given foot soaks much consideration and have determined there are safety and infection control issues involved with foot soaks which prohibit us from providing these.
Products
Diabetic socks are available at big box stores, specialty shoe stores, and foot care catalogs. Toe tubes and doughnut pads are available at drug stores in the Foot Care Section and Foot Care Catalogs. Some of the providers we recommend are as follow: Hapad, Pedifix, or Foot Smart.
The best way to purchase shoes is to find a shoe store with a “trained shoe fitter”. You want someone who knows how to measure your feet and actually fit the shoes to your feet. There are several stores in the SE Wisconsin area with shoe fitters. Check the yellow pages for “shoes- orthopedic dealers” in your area. Call them and ask for a “trained shoe fitter”. If they do not have one or do not know what that is, do not use that store. You will generally pay a premium for properly fit shoes but the store will stand behind their product and make adjustments if they do not work out. If shoes you buy from a big box store do not fit, no one can help you and ALL your money was wasted.
Studies have shown that any type of moisturizer is good, as long as it is used regularly. Use whatever you have, whatever you like, or whatever you can afford. The important thing, as we age, is to use moisturizer on our legs and feet every day or at least with each bath or shower.
We recommend you ask your pharmacist or doctor about treatments for athletes foot problems.
Services
Home visits are done only when there is no clinic nearby or if the client is unable to leave the home for any type of medical visit. The cost is more than double our clinic price and is scheduled at the convenience of our nurses.