Does Medicaid Cover Incontinence Supplies [Get The Facts]

Do you or your loved ones suffer from incontinence and need additional support to be able to perform daily activities without worrying? If you answered yes you are in the perfect spot because we have all the answers for you.

You might wonder if Medicaid will cover the cost of these incontinence supplies considering that the rules and regulations are different in each state. 

We have all the details that might surprise you, so keep on reading and let’s get right into today’s topic.

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What is Medicaid and who is eligible?

Medicaid is one of the biggest medical insurances in the United States, and millions of people now depend on this financial assistance. Unlike Medicare, this program is for all people who are under the poverty line or better-said families and people with low income.

Over the years the Medicaid coverage changed and accommodated the needs of beneficiaries better, but since every state has the right to organize the program as they see fit the rules and regulations can be quite confusing.

If you are not sure some of your medical necessities will be covered you should:

  • Visit our website for the most current information;
  • Check with your Medicaid representative for more details;
  • Contact the number on your health insurance card;

Medicaid benefits can be mandatory or optional, and incontinence supplies are one of the optional benefits. Does this mean you have to pay for the products yourself? Keep reading to find out more.

Who Needs Incontinence Supplies?

People who have moderate and heavy involuntary urinary leakage might be good candidates for different absorbent products called incontinence supplies. The incontinence supplies are usually made for adults that have muscular problems or other illnesses that lead to urine leaking without control, but sometimes even the children can be affected.

Considering that these are the most vulnerable groups of people and Medicaid pays special attention to their needs, it’s only logical that these products are covered by insurance, but is this true?

Does Medicaid Cover Incontinence Supplies?

Yes, Medicaid will cover incontinence supplies in most states, but not all of them.

Like we mentioned before each state will have its own set of rules, so some states chose to leave out incontinence supplies. But, the majority of states will offer some kind of reimbursement for children or the elderly that have problems with urinary incontinence.

The best way to find out if your needs will be met by Medicaid is to contact the local Medicaid agency in your state and ask for additional information. They will be able to help you with eligibility, lost insurance cards, suppliers, and benefits you might have with Medicaid.

This condition might be more present than you believe, and it’s affecting over 13 million people. This is also a pretty limiting illness that restricts the daily activities of the afflicted person so having additional support can mean a lot.

With various products and manufacturers, you can choose what is the best option for your needs and daily life. The products might not be expensive, but the overall cost can become too much for families that are living on a tight budget.

Types of Incontinence Products Covered by Medicaid

Depending on the condition of the patient, age, and other factors there are different incontinence products on the market.

Here are a few examples you should know about:

  • Bladder Control Pads
  • Male Guards
  • Protective Underwear/Pull-Ons
  • Adult Briefs
  • Booster Pads
  • External/Condom Catheter
  • Underpads

At the beginning of urinary problems and incontinence, most patients need only light support like pads or guards. But, as the illness progresses you might want to use something more absorbent and secure like briefs and underpants.

The product is designed to be extremely absorbent but comfortable to wear, so there will be no added inconvenience.

How to get incontinence products with Medicaid?

Getting the best care and using your Medicaid benefits can be difficult to understand sometimes. One of the most important things to keep in mind is that Medicaid will cover any medical procedure as long as it’s considered necessary.

This medical necessity is a loose term that is mainly left to your doctor to determine. But, in most cases, if something is needed for daily activities and comfort it will be covered. 

This is why you need two things when you are trying to get Medicaid to cover your incontinence supplies:

  1. A prescription with a qualifying diagnosis;
  2. Type of products needed (estimated units per day);

Your doctor will assess your state in a thorough exam and suggest the right product for your flow. In case you are not sure what would be the best solution for you you can ask for different samples and brands.

It’s important to have an honest conversation with your physician for the optimal assessment. This will help you or your loved ones find the best care possible.

Conditions associated with incontinence

Urinary incontinence can be caused by many conditions and it’s important to get the evaluation considering that you will need the documentation to be eligible for the coverage.

Here are a few conditions that will most likely cause incontinence:

  • Prostate Issues
  • Overactive Bladder
  • Stroke
  • Multiple Sclerosis
  • Dementia
  • Spinal Injury
  • Diabetes
  • Parkinson’s Disease
  • Spina Bifida
  • Cerebral Palsy
  • Obesity
  • Alzheimer’s

Different patients will react to illnesses in their way, so having one of the mentioned problems doesn’t mean you will have incontinence for sure. Even if you have such problems, this is not an uncomfortable conversation with the doctor if you are looking for the best solution.

Final Thoughts 

Medical conditions don’t have to be terminal to have a major impact on the patient’s life. Sometimes even the small things like light urinary leakage can create anxiety and problems with daily activities.

It’s comforting to know that Medicaid in most states recognizes the problem and offers beneficiaries full financial support.

David Duford
Author: David Duford