We had written an article last year on whether Medicare covers disposable diapers. The response has been surprising and we have received hundreds of calls since the article was first posted. In response to this overwhelming interest we are updating our previous article and will hopefully help answer the question, "Will Medicare Pay for Adult Diapers".
Original Medicare (Part A), does not cover incontinence supplies such as adult diapers for any condition while living independently or in assisted living. Even though diapers are classified under the broad category of Durable Medical Equipment (DME), Medicare makes an exception for adult diapers and other disposable incontinence products and carves these items out as non covered medical equipment. It's believed that incontinence supplies are not covered due to the length of use as once they have been used they are thrown away. Please, do note that if an individual is hospitalized or admitted to a skilled nursing facility, Medicare Part A will cover diapers while under this care.
Medicare Part B - does not cover adult diapers, however, will cover other incontinence products like external urinary collection devices and disposable catheters for intermittent, self catheterization when coverage criteria are met and the individual or caretaker can perform the procedure.
Medicare Part C - can cover adult diapers, however, this depends on the plan. Part C (Medicare Advantage) plans allow you to choose to receive all of your healthcare services through a provider organization. These plans may help lower your costs of receiving medical services, or you may get extra benefits for an additional monthly fee. You must have both Parts A and B to enroll in Part C. Coverage for adult diapers and other disposable incontinence products are provided to members under select Medicare Advantage PPO plans. Since Original Medicare does not cover adult diapers, the scope of the benefit, reimbursement methodology, maximum allowable payment amounts and member cost-sharing are determined by the member’s group. If an individual has a Medicare Part C Plan they should speak to the plan administrator to see if the plan covers adult diapers or other disposable incontinence supplies.
In summary, Medicare does not cover adult diapers or other disposable incontinence supplies, unless the you have a Medicare Part C plan that allows for this type of coverage. If you have an Advantage Plan then speak with your administrator to see if adult diapers are covered or if the coverage could be added on for an additional cost.
We hope this helps answer the question as to whether adult diapers and incontinence supplies are covered by Medicare.
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