diaper prescription fraud

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Calico said:
Lot of insurances don't cover diapers so families or IC people have to buy them themselves. I have heard of people getting diapers through the state but I think they are the minority and it's rare to get premium brand diapers from them.
The closest to premiumyou will get are wings or Fitzgerald quality..and a shrink will not prescribe because that's a urologist job!
 
Some states pay for Tranquility ATN, but only a few, and even then, ATN's are the Cadillac of insurance paid diapers. A GP can prescribe them, if the person has a pre-existing condition known to cause IC. I'd imagine a neurologist can, too. That being said,
StormTroper said:
No, just no. Save yourself the trouble of trying to cover up lies and just buy your own diapers instead. Not worth it!

It's sad. Sis needs much better quality, as mom works, and sis is difficult to lift and change. Her urine is toxic, as she shares the same genetic kidney problem as mom. It weakens both their immune systems, and being that sis can usually only be changed twice daily, mom must constantly touch wet clothes. If one qualifies for a prescription, it should be better than Walmart quality!:censored:
 
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No, just no. Save yourself the trouble of trying to cover up lies and just buy your own diapers instead. Not worth it!
 
SpAzpieSweeTot said:
Some states pay for Tranquility ATN, but only a few, and even then, ATN's are the Cadillac of insurance paid diapers. A GP can prescribe them, if the person has a pre-existing condition known to cause IC. I'd imagine a neurologist can, too.

It's sad. Sis needs much better quality, as mom works, and sis is difficult to lift and change. Her urine is toxic, as she shares the same genetic kidney problem as mom. It weakens both their immune systems, and being that sis can usually only be changed twice daily, mom must constantly touch wet clothes. If one qualifies for a prescription, it should be better than Walmart quality!:censored:

My state still covers traquility thank God because when I can not wear my cloth I still need a halfway decent diaper!
 
I was faced with this question recently actually. You see I started to become IC only a year ago (January 2014). The only reason why I did not defecate all over the place in front of over 20 people was because I was already wearing a diaper when it happened (I was freakishly about as ready as one could get when their first incontinence accident occurs) . I did not even go to my primary doctor with this until March because I thought it was just me getting sick from something that I ate which is a occasional (once a year) occurrence. Well since then I have been through a number of tests that involve shoving a camera up both orifices to take a look inside 3 times. In fact I just got done with the 3rd this Tuesday. When I finally told my primary doctor about it I also told her that I was a AB/DL to let her know that I am not a liar and to allow myself to be subjected to whatever she felt was necessary to prove that. Well I got a diagnosis of over active bladder from the urologist due to some neurological issues possibly but more likely I simply just held my urine for to long when I was younger while simultaneously not drinking enough water making the nerves overly sensitive. That being said it was a nightmare for me because I am in the middle of a lawsuit against someone for failing to reasonably accommodate me and I am most likely going to have to appear before a judge and explain to them that I wear diapers and why I usually stand in order to avoid ruining the seats wherever I go. About the only thing I could think of regarding this was how I did not have the proof that I really was IC until Tuesday this week and here I am getting diapers (Tranquility slimlines at that) for free now for over a year. Sure looks "convenient" in front of a judge until people realize that I was one of those AB/DL's that really never liked using his diapers for their intended purpose because of the smell they caused. I'm just glad I have a Urologist and my primary doctor to back up that claim now.


For those who continue to think that they could get away with fraud like this I think I can demotivate them by saying something really unpleasant. If you don't mind having 6 feet of tubes shoved up your urethra and/or anus then hope that your doctor is incompetent enough to misdiagnose you but not somehow damage your organs just for free diapers then by all means go for it actually. It is not only difficult to fake this but it's almost impossible to get away with this as well. I seriously think that I have enough fingers to count the number of people who tried this with any kind of "success" in the last 60 years.

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SpAzpieSweeTot said:
Actually, if the person is 5 or older, and IC or untrained for medical reasons, they qualify for an Rx, especially if the IC would still exist even with meds, my sister for one.


Yeah that's how I got my prescription actually I think.


Even if the IC is incomplete, if a lesser degree of protection presents a functional issue for the patient, ie. peel and stick pads shift to the point that they no longer give the right level of protection, and the patient's disability makes them hard to adjust, a higher level of protection maybe chosen.


Technically speaking this is where I fit into that criteria. Sometimes I can make it to the toilet when I'm home but because I'm 6'6" tall it's rather hard for me to change in even handicap stalls because there's barely enough room for me to even turn around in one of those. I get tab style diapers because it's actually feasible for me to get a bowel accident cleaned up properly without ruining my clothes while I change in one of those tiny boxes.

Super sensitive about it and embarrassed. I suspect if I actually drank enough to be hydrated, it'd be worse.

Don't be embarrassed. Honestly things can get a lot worse actually if you don't drink enough water. I know because that could very well be why I started to become IC myself. Everyone in my neighborhood knows that I'm IC because of the negligence of someone who decided that I did not need to be reasonably accommodated but I am still considered a small time ultimate bad-ass in my area anyways. Why? Because I can get kicked in the groin and not go down screaming like most guys because I have extra padding to absorb the blow actually ironically. :smile:
 
I recommend you stay within the law. No one ever thinks they will get caught. You may also get tripped up in the interview by doctor's. It would be insurance fraud. I know what it's like to be out of diaper money. I am on disability. I wear infrequently and wet rarely. Try to hold out. Please, we have enough Americans in jail. Don't be one. They also have tests that determine incontinence and it will be determined that you are not incontinent. They will be looking for problems with our urinary system and won't find any. I am 41, take my advice and warning. You would get caught. Not worth it bro!:hug:
 
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Diapers and incontinence supplies seem to fall under the "iyou buy them" but if you have a FSC (flexible spending account) you can use that account to pay for them.
 
I have at least 3 pre-existing condition known to cause IC.

i buy my own diapers because i like and wear premium diapers.

i live on a tax free disablity pension.

But next year i will hit 65 and go on SS. VA disability and a company retirement.

Then as i will have to pay taxes on part of my income i will write off the premium diapers under medical cost.

One thing i have found is i pay no more for the premium diapers then i would for the cheap ones as i have to change a lot less often.
 
If you wear premium diapers like the Abena M4 24/7, at three changes a day, you’re still only talking around $1,600-$1700 a year (XP Medical prices). You really want to commit the criminal act of medical insurance fraud for such a low payoff? The risk is out of all proportion to the reward. As one of my accountancy instructors once said when discussing the example of a senior executive who destroyed his career by fiddling his expenses to the tune of only about five per cent of his salary “if you’re going to sell your soul, at least get your money’s worth. Even if I were inclined to commit fraud, I personally wouldn’t do it for less than eight digits”.

In any case, there’s no guarantee that you’ll actually save money. You’ve got to consider the cost of days off work to attend medical appointments, transport there, co-payments on tests – it adds up.

So, I'd say its theoretically possible to get away with it, but you'd need to be a very good actor, be willing to put up with a lot of trouble and unpleasantness, and to take a huge risk, all for a very low payoff. It would be irrational.
 
Wow, old thread. . .meh

With my insurance, I can be stocked in more diapers than I could ever use. . ..however, only if there was a diagnosed underlying cause of incontinence, not just the symptom.

To diagnose anything, they will have to perform several potentially painful and expensive tests, which in my opinion make faking it immediately not worth it, never mind what could happen should you be accused of fraud.

I would consider that I would personally use 4-5 diapers a day, should I go 24/7. As I only use the generic store brand, that is roughly $80 a month, including other supplies. In a single year, it would only cost about $1000. A simple ultrasound on my insurance cost $600. ( yeah, I had to do that for another issue. . .thank god for being a low-income student) I cannot imagine how much a cystoscopy and urodynamic testing would cost. I suppose in the long run it would be better, but maybe I change my mind in the future. . .not I am stuck and need to come up with a different lie.
 
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