By Daniel Petkevich
Dec 22, 2022
Over 50% of people aged 65+ experience incontinence.
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.
Incontinence is the loss of control over one's bladder or bowel movements.
The following factors can cause incontinence:
Muscle or nerve damage
Urinary tract infections
Age-related changes — weakened muscles or decreased sensitivity in the bladder
Medical conditions — diabetes, multiple sclerosis, and Parkinson’s disease
Incontinence products provide extra protection from leaks. You can use the following supplies to manage incontinence:
Bed and chair protection
Catheters and penile sheaths
Skincare and hygiene products
Specially adapted clothing and swimwear
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).
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)
Bladder Sling Surgery — treatment for stress incontinence
Note: Medicare covers these treatments only if your doctor declares them medically necessary.
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.
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.
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
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.
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.
Here are a few ways you can save money on your incontinence supplies:
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.
Non-profit organizations — diaper banks, food banks, senior centers, or other community resources — may provide adult diapers for little to no cost.
Many manufacturers offer coupons and discounts for adult diapers and incontinence products. You can find them on company websites or in stores.
Buying larger quantities of incontinence supplies can help you save money in the long run.
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
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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