Medicare for diapers?

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Isle

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  1. Diaper Lover
I have a diagnosed frequent urination problem for which I have been able to get the catheter type devices with leg bag. Actually they work pretty well especially for long stretches where changing a diaper is a problem. Thing is I am now preferring diapers and am wondering if Medicare covers the cost of this (or part B supplement)? Anyone have any experience with this? Are you able to get diapers with a prescription? IF so do you have a choice of diaper and what distributors honor prescriptions?
 
Medicare any part does not cover diapers unless you are in a facility such as Hospital, at home for diapers you have to have your state's Medicaid to pay for them, it requires a diagnosis of IC from a doctor (any will technically do but a urologist will cut the red tape quicker) also if a catheter and bag are doing the job typically diapers are an escalation in the level of care you require, unless you have a situation where it is incontinence as well as retention ( yes that sounds like opposite ends of the spectrum) ultimately it's the law that you can only use 1 style of catheter that you qualify for say for example you use a single intermittent hydrophilic catheter 4 Xs per day to drain your bladder, and decide that due to travel needs a self contained system with a cath that advances out of the collection device would be really helpfull, that can not be accommodated you have to indecent lyrics qualify for the closed system and then give up your intermittent and use the closed system all the time (qualification for a closed system is a minimum of 2 serious UTI or bladder or kidney infection or more within a 6 month period) the rules make perfect sense to a pencil pusher in an office somewhere but play out far differently in real life. Now if you live in any kind of government subsides housing any money you spend on medical needs outside of what the system payday for can be deducted from your income thereby lowering your rent. Seems clear as mud right ,need more info just ask I have become a defacto expert in CMS and there regs in urology.

Peace
 
Missed your last question the first time sorry ,you have your choice of any distributor that carries diapers, the Cadillac of diapers available under insurance is the Tranquility ATN ,provided your state will pay for that level of quality,I only know a couple of states that pay for those left,most places you will find prevail, wings, or first quality, depends are also a choice,now in my case I get my diapers shipped to me from the last distributor in the US that will even bill for ATN'S that is for all intents and purpose on the other side of the country. Your local brick and mortar medical supply will have an exclusive contract to provide 2 different brands of low quality diapers they will not make an exception no matter what because the contracts they sign have among other things a non compete Clause that if caught violating will cost them a bundle. Like my local supplier that I have bought my two power chairs bed recliners etc are over at my house all the time and even though they sell other products made by MEDLINE they can't supply my diapers because of there exclusive contracts with two other companies. Basicly the more money they can save giving you lousy protection goes in there pocket.
 
Maybe you can look into supplemental plans that work with Medicare. Even with my insurance, I would only be able to get Tranquility. I have HSA and can't even spend that money on something decent. Even though it's basically a savings account for health related issues, I can't get what I want. B.S. If you ask me.
 
Thanks for this. I have an appt with urologist Friday and I thought I might ask, but it does not sound promising. Plus if the best I can get is ATN, may not be worth it. I do want to continue getting the catheter, they are useful and good quality.
 
Isle how did Friday go with your urologist?.

I myself cath 5 X's a a day with Coloplast 14 FR coude and wear ATN'S when not wearing my cloth and plastic pants,however I do buy Northshore for long road trips to the Doctor 6 hours each way,little opportunity to change and have to squeeze in the Dr's appointment and ground travel to the office and back in less than 2 1/2 hours in order to catch the bus home before transit in my town shuts down and I am stuck outside a closed bus station on the lake shore in native 15 below not counting windchill ,it happened a couple years ago and was like he'll on earth,if my wheelchair batteries had juice I could have escaped to a warm nearby Hospital but no power no go,and the disability I have leaves me unable to regulate body temperature and the cold causes an exponential increase in my pain issues ( sounds like a bad joke but 8 years ago I took a hot shower in 95 degree summer and ended up hypothermic critical condition at the E.D for rewarding just under 3 hours later, it's the first time the hospital ever treated hypothermia in the summer but due to living on the great lakes they were pretty good at it from lots of winter practice and saved my carcass )
 
Medicaid not Medicare covers for diapers. How much and what kinds of diapers? That depends on the state you live in. I know because I myself have used Medicaid (when I lived in Ohio not here in Montana) to get coverage for diapers among other things.
 
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Hello,

Here in California my Medi-cal covers my diapers. I get 120 a month, enough for 5 a day. But they are the cheaper Wings Choice Plus which are similar to store brand quality. Due to their poor compacity I have to use two at once with the plastic backing of the first one having several slits cut in it so when the first one is soaked it can drain to the next. Otherwise I only get 3 hours per diaper. But because I only get 5 from insurance, the other 3 I buy out of pocket. But since I have choice of what I buy out of pocket I buy the Wellness Briefs and using one a day overnight and then use the 5 wings diapers during the day since the Wellness briefs are good for 6-8 hours and hold what 4 wings diapers can hold. Just have to find a system that works. I am just grateful to get the diapers I do. It saves me quite a bit of money having my insurance covering 80% of my monthly diapers for me. But yes, you have to be diagnosed with incontinence from a urologist.

-Stanley
 
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