Does Medicare Cover Incontinence Supplies? 

Incontinence can be a frustrating and embarrassing medical issue. The cause of incontinence can come from a variety of sources, including bodily changes after pregnancy, bladder and kidney diseases, and disorders of the prostate in men. Symptoms of incontinence may include the inability to control urinary or bowel functions, urges to use the bathroom and unknowingly urinating or defecating outside of normal bathroom visits.

How is incontinence treated?

Incontinence treatment depends on the cause. For incontinence that is caused by organ dysfunction or diseases that affect organs, medication support may be the answer. In severe cases, surgical intervention may be required to correct a problem internally.

Incontinence supplies that include adult diapers and underwear liners may also be used to reduce the chances of an accident. Additionally, some people use waterproof sheets for bedding to reduce the potential for bodily fluids to get on traditional bedding if nighttime incontinence is an issue.

Does Medicare cover incontinence supplies?

Seniors often inquire as to whether Original Medicare covers incontinence products. Most products are purchasable at retail pharmacies, department stores and grocery stores, and they generally do not require a prescription outside of medications.

Unfortunately, Original Medicare does not provide coverage for incontinence supplies in the form of sanitary products. This means that Medicare recipients are responsible for 100% of the cost of these items.

Despite Medicare’s lack of coverage for incontinence supplies, Original Medicare may cover prescription medications used to treat incontinence. Medicare benefits under Part D provide prescription drug benefits. This coverage is optional, and it requires a monthly premium. In addition, Medicare Part D also has a deductible that Medicare recipients will need to meet before benefits begin to apply toward healthcare costs.

If your prescriptions are covered under Medicare Part D, they will be listed in your plan’s formulary. This list may also provide details about quantity limits on certain medications as well as approved generics that may be available.

Original Medicare’s coverage of incontinence surgery

If outpatient surgery is an option that you and your doctor feel is best to treat your incontinence, Medicare coverage is usually available through Medicare Part B, the outpatient portion of Original Medicare. Part B provides coverage for surgical procedures, office visits and lab and diagnostic testing. It also provides coverage for durable medical equipment which may be prescribed to assist Medicare recipients who have a difficult time accessing bathroom fixtures at home.

Inpatient coverage for incontinence

If you are hospitalized and receive treatment for incontinence, Medicare Part A would supply benefits. This is the inpatient portion of Original Medicare, and it provides time-limited coverage for treatment while admitted to Medicare-approved hospitals and skilled nursing facilities.

Do Medicare Advantage plans cover incontinence supplies?

Because Medicare Advantage plans provide the same coverage as Original Medicare plans, they do not cover incontinence supplies as a part of Medicare’s Part A and Part B benefits. These plans may, however, provide plan recipients with the ability to receive discounts on or reimbursements from the purchase of certain over-the-counter incontinence products. These discounts will often apply only to certain brands of products or products from specific manufacturers. Additionally, discounts may only be available in the form of coupons that are redeemed at checkout.

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