How to Receive Incontinence Supplies through California Medicaid

california medicaid caring for someone with incontinence healthcare provider incontinence supplies medical vists

California’s Medicaid Program, also known as Medi-Cal, is a state-funded insurance program that offers coverage for low-income adults, children, pregnant women, senior citizens, and people living with disabilities. 

Can I receive incontinence supplies through Medi-Cal?

Yes, California Medicaid provides incontinence products to eligible individuals. Medi-Cal covers incontinence supplies when prescribed by a physician for use in chronic pathologic conditions that cause incontinence to the insured individual. These medically necessary items include protective underwear, disposable underpads, bladder control pads, and reusable underwear. 

What are the requirements to receive incontinence supplies from California Medicaid?

You must be actively enrolled in a California Medicaid plan. Medi-Cal does not reimburse for incontinence supplies for recipients younger than 5 years old, unless incontinence is due to a chronic physical or mental condition (such as cerebral palsy or developmental delay).

In order to receive incontinence supplies from Medi-Cal, 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

Are SPC incontinence supplies covered by Medi-Cal?

San Pablo Commercial is contracted with the California Department of Health Care Services (DCHS) and is included in Medi-Cal’s list of Incontinence Supplies. Our products have HCPCS billing codes and are reimbursable to accredited and authorized Medi-Cal providers. Medical supply providers should verify a recipient’s eligibility for the month of service before dispensing supplies. Claims received for services rendered to ineligible recipients will be denied. 

How to receive SPC incontinence supplies through Medi-Cal?

If you are interested in receiving incontinence supplies, please search for a Medi-Cal provider and contact them directly. Due to the HIPAA Privacy Rule, San Pablo Commercial does not handle insurance reimbursement claims for our customers. If you have additional questions or need assistance, please call the Medi-Cal Member Hotline at (800) 541-5555. 

How to determine if you are eligible to receive Medi-Cal benefits?

Medi-cal eligibility is based on your income. To determine if you are eligible to receive Medi-Cal benefits, use the Covered California Income Guidelines chart to see if you qualify.

How to apply for Medi-Cal coverage?

If you are eligible for Medi-Cal coverage, you can apply for health coverage via the following options - in person, by phone, by mail, or online. You can apply in person at your local county social services office or give them a call by phone. You can apply by mail with a Single Streamlined Application. Send the completed and signed application to Covered California P.O. Box 989725 West Sacramento, CA 95798-9725 or to your local county office. You can apply online via the Covered California website by submitting an online application. If you need help applying or have any questions, you can call 1-800-300-1506 to be connected with a Certified Enrollment Counselor (CEC).

 

San Pablo Commercial is a family-owned, small business with a mission to deliver affordable medical supplies to their customers. We offer a variety of incontinence products including SPC underpads, bed mats for children, tuckable bed protectors for potty training, and disposable bed pads for bedwetting. We ship directly to our customer’s home within 2 to 3 business days. 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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