Does Medicare Cover Incontinence Supplies?
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Does Medicare Cover Incontinence Supplies?

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By Daniel Petkevich

Dec 22, 2022

Find out how to save on your incontinence supplies

Over 50% of people aged 65+ experience incontinence.

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People can manage the condition with incontinence supplies, but costs add up over time and can become a long-term burden.

Luckily, there are several ways to save money on these products. Keep reading to find out how.

What is Incontinence? 

Incontinence is the loss of control over one's bladder or bowel movements. 

What Causes Incontinence?

The following factors can cause incontinence:

  • Muscle or nerve damage

  • Urinary tract infections

  • Prostate problems

  • Pregnancy

  • Childbirth

  • Certain medications

  • Age-related changes — weakened muscles or decreased sensitivity in the bladder

  • Medical conditions — diabetes, multiple sclerosis, and Parkinson’s disease

What Products Can I Use to Manage Incontinence?

Incontinence products provide extra protection from leaks. You can use the following supplies to manage incontinence:

  • Incontinence pads

  • Absorbent briefs

  • Protective underwear 

  • Bed and chair protection

  • Catheters and penile sheaths

  • Skincare and hygiene products

  • Specially adapted clothing and swimwear

Does Medicare Cover Incontinence Supplies?

Typically, no. Medicare doesn't cover adult diapers, incontinence pads, protective underwear, or bedwetting products.

Why? Medicare doesn't consider incontinence supplies to be durable medical equipment (DME).

Does Medicare Cover Other Incontinence Services?

Yes. Medicare Parts B might cover some incontinence services, including:

  • Outpatient care — your doctor visits

  • Durable medical equipment (DME) — bladder scanners, urological supplies, catheters and collection devices, intermittent positive pressure breathing (IPPB) machines and their accessories, enteral nutrition pumps, or ostomy products

  • Home health services 

  • Incontinence-related preventive services

Depending on your condition, Medicare might also cover the following:

  • Percutaneous Tibial Nerve Stimulation, or PTNS — a procedure that uses electrical stimulation to help improve bladder control

  • Oxybutynin — a drug used to treat symptoms of urinary incontinence and overactive bladder (like frequent urination, urgency, and urge incontinence)

  • Urodynamic testing — tests used to evaluate the function of the urinary system (i.e., the bladder and urethra)

  • Emsella — a non-invasive, electromagnetic stimulation therapy designed to strengthen the pelvic floor muscles

  • Bladder Sling Surgery — treatment for stress incontinence

Note: Medicare covers these treatments only if your doctor declares them medically necessary.

Will My Medigap Plan Help Cover Incontinence Supplies?

No. Medigap plans, also known as Medicare Supplement plans, are extensions of Original Medicare and help cover some of your out-of-pocket costs left after Medicare coverage.

Since Original Medicare doesn't cover incontinence supplies, Medigap plans don't either.

How Can I Get Coverage for My Incontinence Supplies?

While Medicare doesn't cover incontinence supplies — like adult diapers, incontinence pads, protective underwear, and bedwetting products — you can still get coverage for these items.

Here's how:

1. Enroll in a Medicare Advantage Plan

Medicare Advantage plans (AKA Medicare Part C) are offered by private insurance companies. They cover the same services as Original Medicare (Medicare Part A and Part B) but some have added benefits.

Some Medicare Advantage plans cover incontinence supplies — like disposable adult briefs or pull-ups, bladder control pad guards, and bed underpads. 

However, exact coverage varies depending on your plan.

  • If you’re enrolled in a Medicare Advantage plan, ask your insurance provider if your plan covers incontinence supplies

  • If you’re not enrolled in a Medicare Advantage plan, reach out to your insurance provider for information on available plans in your area and the coverage rules for each one

2. Enroll in Medicaid

Medicaid is a joint federal and state program that provides health insurance coverage to low-income individuals and families. If you fall under the low-income category, you may be eligible for Medicaid benefits.

However, Medicaid coverage for incontinence supplies varies by state. In other words, some states cover these supplies through their Medicaid program, while others do not. In addition, some states may have brand restrictions or monthly limits on the number of incontinence supplies covered under their Medicaid program.

3. Get Veteran’s Health Care

If you’re a veteran diagnosed with incontinence, you might get coverage for your incontinence supplies through your VA health benefits. 

However, the VA usually supplies a standard type of adult diaper that may not meet your individual needs. In this case, your doctor can prescribe or provide a medical justification for a different brand that's more suitable for you and explain why it's a better option.

How Can I Save Money on My Incontinence Supplies?

Here are a few ways you can save money on your incontinence supplies:

1. HSA and FSA

Money in a Health Savings Account (HSA) is not subject to federal income tax. It can be used to pay for "qualified medical expenses" as determined by the Internal Revenue Service (IRS).

Incontinence supplies are considered a qualified medical expense. So you can use this tax-free fund to pay for your incontinence supplies, potentially saving money.

Similarly, money in a Flexible Spending Account (FSA) is not subject to federal, state or social security taxes and can be used to buy incontinence supplies.

Note: If you’ve delayed enrolling in Medicare because you're on private insurance and contribute to an HSA within 6 months of your Medicare enrollment, you might face a tax penalty.

If you’re enrolling once you turn 65, you need to stop making contributions a month before your start date.

2. Charitable Organizations

Non-profit organizations — diaper banks, food banks, senior centers, or other community resources — may provide adult diapers for little to no cost.

3. Use coupons and discounts

Many manufacturers offer coupons and discounts for adult diapers and incontinence products. You can find them on company websites or in stores.

4. Buy in bulk

Buying larger quantities of incontinence supplies can help you save money in the long run.

Can I Get Free Adult Diapers?

Yes. You can access free adult diapers in the following ways:

  • Medicaid — Medicaid programs in some states provide free incontinence supplies under certain conditions

  • Charitable organizations — Some non-profit organizations (e.g., diaper banks, food banks, senior centers, or other community resources) may provide adult diapers for free

  • Manufacturer samples — Some manufacturers offer free samples of their products to try before you buy

Takeaway

Incontinence is a common condition that can be challenging to manage, especially for older adults. Incontinence supplies can provide relief but can be expensive over time. Medicare does not typically cover incontinence supplies — such as adult diapers, pads, and undergarments.

However, if you're enrolled in a Medicare Advantage Plan or are eligible for Medicaid, you might get coverage for your incontinence supplies.

You can also save money on these products by finding discounts, seeking help from local non-profits, or using your HSA or FSA.

Contact your insurance provider regarding the coverage options for incontinence supplies under your plan. You can also talk to our advisors at 1-888-376-2028 if you need assistance. We can explain the intricacies of Medicare and respond to any questions you may have.

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Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.


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