Does Medicare Cover Urinary Drainage Bags? 

As people get older, urinary problems become more common, and they’re often due to changes in the kidneys and bladder. With age, kidney tissue and blood vessels harden and the kidneys filter blood more slowly. The bladder loses its elasticity, and the muscles weaken, making it more difficult to store urine. 

Men older than 60 often experience an enlargement of the prostate gland that can block the urethra and prevent the bladder from emptying completely. This condition can cause discomfort, problems urinating, and more serious complications like urinary tract infections and chronic kidney disease.  

Your health care provider might prescribe a urinary catheter for you if:

  • You can’t control when you urinate. 
  • You’re experiencing urinary incontinence. 
  • You can’t urinate at all. 

These symptoms listed above could be the result of medical conditions such as: 

  • Stones in the bladder or kidneys
  • Blood blots in your urine
  • Benign prostate enlargement that is severe
  • Prostate surgery
  • Bladder nerve injury
  • Spinal cord injury
  • Dementia
  • Certain medications

If your doctor prescribes a urinary catheter to relieve your medical condition, you’ll need supplies that you can use at home and change frequently to avoid infection. Here’s a look at whether you can get help from your Medicare insurance to cover these expenses. 

Does Medicare cover urological supplies like urinary drainage bags? 

There are three types of urinary catheters: indwelling, external, and short-term. They are made of a rubber, PVC plastic, or silicone tube that is placed through the urethra and into the bladder. The tube collects urine from the bladder which empties into the attached urinary drainage bag.  

How long you need to wear a catheter and urinary drainage bag depends on your medical condition. In most cases, you’ll need to wear one until you can urinate on your own again. However, many older adults have a permanent health condition or a severe illness that requires permanent or long-term use of urological supplies. 

Original Medicare Part B (medical insurance) covers medically necessary urological supplies under the durable medical equipment benefit, and includes the following items in limited numbers per month:

  • Three types of catheters: Intermittent, external, and indwelling 
  • Urinary drainage bags
  • Irrigation kits
  • Bedside drain bags
  • Leg bags for urinary drainage
  • Irrigation syringes
  • Extension tubing
  • Other miscellaneous supplies such as tape, gloves, and sterile catheter lubrication packets

Medicare covers a certain number of urinary drainage bags per month depending on what type of catheter you’re using and your medical condition. To be eligible for this benefit, your health care provider (who accepts Medicare assignment) must certify that the supplies are medically necessary to treat your condition. You must get the items from a durable medical equipment supplier who accepts Medicare assignment. 

Original Medicare Part B pays 80 percent of the cost of urological supplies like urinary drainage bags, and you pay the remaining 20 percent after paying your Part B deductible for the current year. 

If you are enrolled in a Medicare Advantage (Part C) plan, your provider must cover any benefits that are covered by Original Medicare Parts A and B if you’re eligible for them. Many Part C plans also include additional coverage and extra benefits, so your plan may allow a greater number of urinary drainage bags per month. 

Depending on the type of Medicare Advantage plan you have, you might be restricted to using certain medical suppliers who are within your plan’s network. Check your policy for details before making any purchases of urological supplies. 

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