Medicare Navigating the intricacies of Medicare can often be a daunting task, especially when it comes to knowing exactly what is covered under its various plans. Incontinence supplies is one of the most common areas of confusion. Given that incontinence affects millions of Americans, knowing how to access Medicare benefits for these necessary supplies is important for many people and their caregivers.

The Scope of Incontinence

It is estimated that about 25 million Americans1 have some form of incontinence, which is the involuntary release of urine or feces. By virtue of its widespread occurrence in the elderly population and the significant impact it has on quality of life, sciatica presents a double whammy — physical and emotional. Causes of the condition can vary from age-related changes to diabetes or neurological disorders.

Limitations of Coverage under Medicare

Medicare is a federal health insurance program mainly for those 65 years of age and older, but Original Medicare (Part A and Part B) does not usually cover incontinence supplies. Despite all the supplies provided such as adult diapers, pads and protective underwear, these are generally classified as personal convenience items which is why Medicare does not cover them.

However, there are other options and exceptions for beneficiaries to help reduce the cost incontinence supplies. Depending on the plan and your local state, Medicare Advantage Plans (Part C) and Medicaid might cover some chiropractic visits.

Medicare Advantage Plans for Incontinence Supplies

Medicare Advantage Plans, which are still a type of health insurance through private insurance companies that accept the authorized payment plans of Medicare, often offer benefits beyond what original Medicare will cover. These plans may offer benefits coverage for incontinence supplies. Beneficiaries should check the specifics of their individual Medicare Advantage Plan to see whether incontinence supplies are covered and if so, to what degree.

While choosing the correct Medicare Advantage Plan, one must look out for monthly premiums, out-of-pocket expenses, and the suppliers available in the network. Beneficiaries can also call the plan provider directly and ask about the details of their incontinence supply coverage.

Medicaid and Dual Eligibility

Note: Dual eligibles (those who qualify for both Medicare and Medicaid) may have additional help with incontinence supplies. A state and federally funded program, many states cover these supplies under their Medicaid programs, but some states cover more than others2.

To learn more about coverage options and benefits and other state specific information, beneficiaries are encouraged to reach out to their state Medicaid office. Medicaid will sometimes cover 100% of incontinence supplies, which will greatly if not completely remove the cost from those that need them.

Costs and Financial Aid Options

Incontinence supplies can be costly, with some estimates suggesting that a person can spend over $900 a year on these necessary items3. If you are not covered through Medicare Advantage or Medicaid, seeking out other financial assistance programs could also be helpful.

There are various non-profit organizations and community programs that can provide help or discounts on incontinence supplies. Also some makers have coupons or samples that could save a pretty penny. Consider exploring these resources to save some dough.

Actionable Steps for Beneficiaries

Here are some steps that can be helpful for those with Medicare who need incontinence supplies:

• Look at what is covered with your existing Medicare Plan and what is likely your minimums and also maximums to a specific extent.
• If you care for someone who uses incontinence supplies, you may be able to save on costs by considering a switch to a Medicare Advantage Plan during the open enrollment period.
• See if you are eligible for Medicaid of other state funded assistance programs that can cover you.
• Check out non-profit organizations and manufacturer discounts for further financial assistance.

These actions assist beneficiaries in minimizing the costs of incontinence supplies and upgrading their living standards.

Final Thoughts

In many ways, Original Medicare's limited coverage for incontinence supplies leaves much to be desired — but when combined with alternative options like a Medicare Advantage Plan or Medicaid, it can offer a great deal of relief. Being aware of these alternatives and ensuring that proper precautions are taken, can help the key individuals handle their incontinence without much of a stretch. However, with the right information and tools, patients and their families can access the help they deserve.

References

• National Institute on Aging - Urinary Incontinence in Older Adults
• Medicaid - List of Benefits
• National Center for Biotechnology Information - Economic Impact of Incontinence