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Does Medicare Pay for Incontinence Supplies?

health insurance plans incontinence supplies medicaid Medicare Medicare Advantage Medicare Supplement Insurance

Does Medicare Cover Incontinence Supplies?

Medicare is a healthcare program that provides numerous benefits to qualifying individuals, especially seniors. However, the scope of benefits may not extend to everything you may need, like incontinence supplies and adult diapers. If you are experiencing loss of control over your bladder, you may need additional coverage for incontinence supplies.

What is Medicare?

Medicare is a federal health insurance program that offers coverage to eligible individuals over 65 years old. It also provides coverage to anyone under the age of 65 living with:

  • a disability, 
  • end-stage renal disease (ERSD), 
  • or Lou Gehrig’s disease (ALS).

Medicare is divided into four parts - Part A, Part B, Part C (Medicare Advantage), and Part DLearn more about what each part of Medicare covers. 

Individuals are first eligible to sign up for Medicare 3 months before turning 65.

Are incontinence supplies covered by Medicare?

Incontinence supplies are not covered by Medicare. Unfortunately, Medicare doesn’t cover the costs of absorbent products, including incontinence supplies or adult diapers. This means you may have to pay 100% out-of-pocket.

What are Medicare Advantage Plans?

Medicare Advantage or Part C, is a type of Medicare plan offered by private insurance companies that must follow Medicare rules. Medicare Advantage Plans typically bundle Medicare Part A, B, and D to provide the benefits of Original Medicare, plus additional benefits. 

Are incontinence supplies covered by Medicare Advantage?

People with Medicare Advantage have some additional benefits based on the type of plan they are enrolled in. If you are enrolled in Medicare Advantage or have Medicare Supplement Insurance (Medigap), you will need to check your insurance benefits to see if your plan covers incontinence supplies. 

If you need more assistance regarding your Medicare plan, please visit the State Health Insurance Program (SHIP). You can also contact the SHIP Technical Assistance Center at 877-839-2675 or send an email to info@shiphelp.org.

Low-Cost or Free Incontinence Supplies

Having the necessary supplies like pads, pants, and other hygiene products make life easier when living with this incontinence. However, it may be difficult to afford incontinence supplies when it is not covered by your insurance plan. Some individuals may be eligible to receive free incontinence supplies through their state’s Medicaid program. 

What is Medicaid?

Medicaid is a federal and state-run healthcare program that offers healthcare coverage and benefits to people with disabilities, seniors, and low-income families or individuals. Medicaid insurance is available to anyone earning a certain income level as determined by Medicaid’s income limits. You can check the Medicaid eligibility requirements to see if you qualify.

Are incontinence supplies covered by Medicaid?

Most state Medicaid plans will cover incontinence products when prescribed by a physician for use in chronic pathologic conditions that cause incontinence to the insured individual. These incontinence supplies include disposable underpads, reusable incontinence underwear, and bladder control pads. This is an affordable way for individuals or caregivers to receive low-cost or free incontinence supplies for seniors.

How to receive incontinence supplies through Medicaid?

If you are looking to get incontinence supplies through Medicaid, you will need to visit your medical provider and have proper documentation which should clearly state these products are medically necessary for your particular condition. 

In order to receive incontinence supplies from Medicaid, you must have the following:

  • A medical condition that requires incontinence supplies (i.e. autism, diabetes, down syndrome, Parkinson’s disease, etc.)
  • Prior authorization and documented proof within the last 6 months from a physician stating the medically necessary items
  • The estimated amount of incontinence supplies needed per day

If you or someone you are caring for is living on a fixed income, getting your incontinence supplies covered by Medicaid can help relieve your financial burden. To learn more about Medicaid incontinence supply coverage, click on your state below:

San Pablo Commercial is a family-owned, home medical device retail facility with a mission to deliver affordable medical supplies to their customers. We offer a variety of incontinence products including SPC disposable underpads, reusable incontinence underwear, sanitary pads, and more. We ship directly to our customer’s home within 2 to 3 business days. SPC disposable quilted underpads are also available on Amazon. We care deeply about our customers and want to make ordering incontinence supplies easier so that they can spend less time cleaning up spills and messes.

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