Original Medicare doesn’t cover adult diapers and other incontinence supplies. Unfortunately, that leaves many older adults paying out of pocket for incontinence items that could run a few hundred dollars a month.
Incontinence products include bladder control pads, protective underwear, adult briefs and underpads, and some older adults go through multiple items a day. About a quarter to a third of U.S. adults experience urinary incontinence, according to the Urology Care Foundation.
Does Medicare Advantage cover incontinence supplies?
Most Medicare Advantage plans offer some type of over-the-counter (OTC) benefit, which members may be able to put toward incontinence products. Over-the-counter options may include men’s guards, protective pads, underwear, barrier ointment and wipes.
Call your provider if you have questions about coverage.
Medicare coverage of incontinence treatments
Although Original Medicare doesn’t cover incontinence products, if your doctor prescribes or recommends a certain treatment for incontinence, Medicare may cover it. Some examples include:
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Pelvic devices: In 2021, Medicare started covering Elitone, a device that uses external pelvic stimulation to help women reduce symptoms of incontinence. Medicare may also cover internal pelvic floor electrical stimulators if you’ve tried and failed at pelvic floor training. You’ll need a prescription.
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Catheters: If your doctor has prescribed catheters because you have permanent urinary incontinence or urinary retention, Medicare will reimburse up to 200 catheters a month. Other medical requirements may apply in order to qualify.
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Biofeedback therapy: Medicare may cover biofeedback-assisted pelvic muscle exercise training to try to improve awareness of pelvic floor muscles if you’ve tried and failed at pelvic floor training.
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Incontinence control devices: Medicare might cover a treatment like a collagen implant to treat stress urinary incontinence.
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Surgical treatment: Medicare might cover a recommended surgery such as a bladder sling surgery.
If your doctor recommends a treatment or surgery for incontinence and Medicare doesn’t cover it, you can file an appeal.
Does Medicaid cover incontinence supplies?
Depending on your state and Medicaid plan, you may get some coverage of incontinence items if they’re medically necessary. If you’re on Medicare and Medicaid, you may be able to get all incontinence products covered. You can find Medicaid information for your state at Medicaid.gov.
