Does Medicare Cover Incontinence Supplies?
Medicare does not currently offer coverage for incontinence supplies, however there are some loopholes to consider, such as adult diapers being covered in Medicare Part C. Some Medicare Advantage plans may cover benefits such as over-the-counter supplies, so it’s good to make sure if you’re covered and in which ways.
Original Medicare will help cover medical devices and durable medical equipment that can be used to treat incontinence, such as catheters, in certain circumstances, but the federal health insurance program only covers medically necessary supplies and procedures.
Does Medicare Cover Adult Diapers?
Medicare does not cover adult diapers or any disposable supplies, for that matter. Some Medicare Advantage plans will cover over-the-counter supplies like adult diapers or bandages and gauze, but Medicare will only cover the costs for exams, tests, and lab work pertaining to what’s causing incontinence.
What about Undergarments?
Insurance does not cover disposable supplies, especially if you require a special brand. However, some Medicare Advantage plans may cover well known undergarment brands that can be used to help with incontinence, so be sure to check brand limitations. Additionally, some state Medicaid programs help cover the cost of incontinence supplies.
How About Medicaid, Medigap & Medicare Advantage Plans?
Medigap, which is Medicare Supplement Insurance, does not cover disposable incontinence supplies, but Medicare Advantage will. Medicare Advantage plans are sold privately by insurers and are required to cover everything covered by Original Medicare, along with additional supplies you need or use.
Check available Medicaid, Medigap, and Medicare Advantage plans to see what they cover in your specific area for your individual needs – this is the best way to find out whether your incontinence supplies are covered or not.
How Do I Get Coverage for Incontinence Supplies?
If you need coverage to help pay for incontinence supplies, take a look at nonprofits, your state’s Medicaid program, or a private insurer who can provide you with Medicare Advantage.
Medicaid is a program that helps pay medical bills for people with limited income. You can enroll in both Medicare and Medicaid if you meet dual eligibility requirements. Each state’s set of rules vary in terms of what Medicaid will cover, but the majority provide some level of coverage for incontinence supplies like adult briefs and bladder control pads. Check with your state Medicaid office to learn more.
Department of Veterans Affairs
The Department of Veterans Affairs doesn’t provide adult diapers as part of its health benefits, but it does provide a variation of an adult diaper. If you would prefer a brand name like Depends, your doctor will have to provide the Veterans Affairs Department with a prescription of statement of medical necessity.
Veteran-Directed Care is a Veterans Affairs program providing financial assistance to veterans. It’s designed to give veterans flexibility to determine how they would like to spend their medical aid, and if you qualify, you can use that money towards incontinence supplies.
Other Insurance Plans
Most employer insurance plans provided through major insurers do not cover incontinence supplies, but they may cover catheters. Check with your plan’s administrator to see what is covered for you. If you have a Flexible Spending Account or a Health Savings Account, you can use your pre-tax money in your account to pay for the supplies, including adult diapers and pads.
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