Medicare and most private health insurance programs cover acute medical and surgical foot services, as well as diagnostic x rays and leg braces. Details of such coverage vary among plans. However, routine foot care—including the removal of corns and calluses—ordinarily is not covered, unless the patient has a systemic condition that has resulted in severe circulatory problems or areas of desensitization in the legs or feet. Like dental services, podiatric care is often discretionary and, therefore, more dependent on disposable income than some other medical services.

Employment of podiatrists would grow even faster were it not for continued emphasis on controlling the costs of specialty healthcare. Insurers will balance the cost of sending patients to podiatrists against the cost and availability of substitute practitioners, such as physicians and physical therapists. Opportunities will be better for board-certified podiatrists, because many managed care organizations require board certification. Opportunities for newly trained podiatrists will be better in group medical practices, clinics, and health networks than in a traditional solo practice. Establishing a practice will be most difficult in the areas surrounding colleges of podiatric medicine, because podiatrists are concentrated in these locations.