Medical insurance question?

So i have always been a bedwetter due to a underdeveloped bladder which has been diagnosed by a professional doctor. So is there anyway that my medical insurance will help with the cost of diapers since its a medical condition not just pleasure?


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BrandenDL4ever said:

So i have always been a bedwetter due to a underdeveloped bladder which has been diagnosed by a professional doctor. So is there anyway that my medical insurance will help with the cost of diapers since its a medical condition not just pleasure?


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Absolutely! It usually request at least two insurance denials, and one more independent review. Hiring a lawyer, or otherwise bringing your issue to public view also helps speed things up though. However, be prepared to receive approval for the cheapest, most ineffective, and leak prone, diapers ever created. Congrats on you long, expensive, and hard fought win though.

Slomo said:

Absolutely! It usually request at least two insurance denials, and one more independent review. Hiring a lawyer, or otherwise bringing your issue to public view also helps speed things up though. However, be prepared to receive approval for the cheapest, most ineffective, and leak prone, diapers ever created. Congrats on you long, expensive, and hard fought win though.

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I contacted my insurance and they, of course, denied any coverage. I have heard that some insurance companies do cover diapers, but as Slomo says, they are often the cheapest, most institutional diapers they can find. Good luck and keep us updated.

Most insurance companies in the US have quit covering incontinence supplies since they have adopted standard medicare definitions for covered services. The definition that gets quoted the most is that its not Durable Medical Equipment because they are not generally reusable, and aren't something that could effectively be used by another individual once the need for the device is gone.

You would need to delve into your insurance policy to really understand if they do or not though, and be prepared to get a diagnosis and prescription from the doctor.

If your place of employment offers an FSA (flex spending account) you can use it to offset the cost somewhat.

If you know about how many diapers you use in a month, you can calculate the total yearly cost of diapers you use. Divide this amount over the number of pay checks you receive in a year. For example, if you use $600 worth of diapers in a year, & get paid bi-weekly, you’d have $24 taken out of your check every payday (25 paydays a year). The $600 is taken out pre-tax so you will end up saving money in the long run.


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Slomo said:

Absolutely! It usually request at least two insurance denials, and one more independent review. Hiring a lawyer, or otherwise bringing your issue to public view also helps speed things up though. However, be prepared to receive approval for the cheapest, most ineffective, and leak prone, diapers ever created. Congrats on you long, expensive, and hard fought win though.

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That is dumb. Some people need prescriptions every day which is “the average American's annual prescription drug tab is $1,370 before insurance coverage” And i just need one lousy diaper at night, I generally only use about 40 diapers a month “I sometimes wear during the day for fun” i just figured i spend all this money on health insurance every year and hardly use it so I figured maybe it could help with cost of diapers even though its only about $60 for a case of M4’s


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BrandenDL4ever said:

That is dumb. Some people need prescriptions every day which is “the average American's annual prescription drug tab is $1,370 before insurance coverage”

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That's just because some big pharma can charge $400/pill for some of their life-saving medications. If you have to take one of those a day, imagine how that skews the averages, at $145,000/yr. (and if you're taking that, there's probably a few other meds in your pillbox that are probably adding another 10-20% onto that)

My prescription medical bill has exactly one item on it, I use high fluoride toothpaste to compensate for poor quality enamel on my teeth. For me that comes to under $40/year.

My insurance company has paid for my diapers for my entire life but I can say that at least every two years they try to weasel their way out of something. It will be an ongoing journey for you for a long time. And they will always try to put you in the cheapest diaper possible. But they squeakiest gear gets the most oil so if you have the tenacity to fight with them you will eventually reach a compromise. And of course be ready to prove your incontinence at the drop of a hat.

Every time my insurance company plays the game, "well we have a new corporate policy that effects your coverage" i'm back at a doctors office getting a bladder pressure test done for no known good reason. I may fall into a separate category since i'm a from birth wearer and never been out of diapers though. Something to research in your free time.

Best of luck. I know they are expensive. I would need a part time job just to keep my medical needs paid for if I didn't have it.

both my medical plans for my diapers I was on State Medicaid before I switched over to VA healthcare. On Medicaid, i was getting Tena brand diaper and on Va, i am not getting Abena Abri M4 plus other supplies granted i am on the lower income being disabled