While those with Medicare cannot get incontinence supplies covered by their insurance, there are methods of getting around the lack of reimbursement for these critical materials. Between Medicare Advantage allowances and HSA cards, you’re bound to find a solution that works for you and your specific plan.
Does Medicare Cover Incontinence Supplies?
No, Medicare does not typically cover incontinence supplies. However, some Medicare-sponsored private insurance plans will reimburse Medicare recipients for diapers, briefs, and other incontinence supplies.
To better understand if your Medicare plan covers incontinence supplies, one must understand the variety of Medicare plans and what they do explicitly. Medicare is a program that provides federally subsidized health care, primarily to people over the age of 65.
Original Medicare comprises parts A and B, with Part A covering inpatient care and Part B covering outpatient care. Each is run solely by the government and does not offer customization. Therefore, if you are looking for care or coverage specific to your situation, in this scenario, incontinence supplies, you may want to consider one of the other Medicare parts.
Medicare Advantage Plans
Medicare Advantage, also known as Medicare Part C, is funded through the Medicare program. However, there is one significant difference: it is purchased by a beneficiary and administered by private insurers.
One advantage of Medicare Advantage is that with the flexibility of private insurance companies comes the potential for customization or additional services not provided by Medicare. Some plans offer discounts or allowances on over-the-counter items, including incontinence supplies. Additionally, some Medicare Advantage plans may offer HSAs, or health spending accounts to alleviate the cost of commonly used products seniors need.
How to Save on Incontinence Supplies with HSAs
One of the best ways to save money on incontinence supplies is to purchase them with an HSA account. HSAs allow Medicare recipients to send and store money in an account without paying taxes. Medicare recipients then use this account to purchase necessities, such as incontinence supplies, without taxes, reducing the products’ overall cost.
Medigap and Incontinence Supplies
Disposable incontinence supplies are items used for bladder or bowel control and are meant to be thrown away after a single use. Disposable incontinence supplies include briefs, protective underwear, guards, liners, shields, pads, and belted undergarments.
Medigap is a Medicare Supplemental plan that covers the financial gaps a Medicare recipient would typically have to pay out of pocket. However, Medigap coverage goes towards copays and deductibles, not products and services.
Getting Assistance for Incontinence Supplies
If a Medicare Advantage plan doesn’t cover incontinence supplies, the Medicare recipient can turn to other programs like Medicaid for help. Medicaid is similar to Medicare but provides medical care free of cost and is available to people of all ages.
Another difference between original Medicare and Medicaid is that each state implements and administers the latter. Because Medicaid is administered by locality, qualifying for it differs by state. Similarly, each state offers different rules and coverages as well. Despite these variances, most include coverage for incontinence supplies, including bladder control pads and adult briefs.
However, if you live in an area without Medicaid coverage for incontinence supplies, there may still be further options. Those who served in the US Armed Forces qualify for VA benefits, including health care. VA healthcare benefits include adult diapers and incontinence pads as part of their benefits.
Finally, non-profit and community organizations exist to provide incontinence supplies to those that cannot afford them. You can usually find these organizations by searching for a “diaper bank” in your local area or searching for a local program with the National Diaper Bank Network. While this program is generally geared towards children and families, they provide services to adults, with 9% of their distribution going towards that population.