Do I qualify

No Cost Shoes Do I Qualify?

You may be eligible for shoes – at no cost to you! Enter your information in the form below to find out if you qualify for shoe coverage. Medicare or your insurance provider may cover the cost of one pair of shoes and three pairs of custom or heat molded insoles per calendar year. Find out if you qualify now!

Besides Medicare, here is a list of private insurance providers: AARP United Health Care, Aetna, Anthem BCBS,ChampVA, Conventry, Empire BCBS, Humana, Blue Cross Blue Shield, Care Improvement, Pyramid, Secure Horizons, United Health Care, Tricare,Wellcare. Any many more.

Personal Information










Medicare and Insurance Information


Supplementary/Secondary Insurance Information



Primary Physician Information (M.D or D.O only No Podiatrist Please








Medicare Covered Products (Check next to each product you want to receive)

Tens UnitSeat LiftBack BraceAnkle BraceKnee BraceWrist BraceCompounded Cream

Confirm & Submit Application

By submitting this information, I authorize NoCostShoes.com/Quantum Medical Supply Inc., its affiliates, subsidiaries, or parent company to contact me by phone or email. Please be assured that we value and protect your privacy. Remember, there is no purchase necessary to see if you qualify.

Contact Us

  • 7401 Wiles Road
    Suite 139 Coral Springs, FL 33067
  • 954-509-3820

Information on this site is provided for informational purposes and is not meant to substitute for the advice provided by your own health professional.

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