Incontinence affects millions of people across the country, especially adults over the age of 65. Does Medicare cover incontinence products? If not, what can individuals who have Medicare do to save money on the incontinence supplies they need to enjoy a happy, healthy life?
UnderX is committed to providing high-quality, affordable, and sustainable incontinence supplies, and knowing more about Medicare incontinence products can help you make the right choices for your needs and your wallet.
What Is Medicare and Who Qualifies?
Medicare is a federal health insurance option available to adults over the age of 65 and some adults under 65 if they have disabilities, Lou Gehrig’s Disease (ALS) or end-stage renal disease (ESRD). Numerous insurance providers offer coverage under the Medicare program, including well-known insurers like Humana, Aetna, BlueCross BlueShield, Mutual of OMaha, UnitedHealthcare, and numerous others.
The program is divided into four parts – Medicare Part A through Part D.
Does Medicare Cover the Cost of Incontinence Supplies?
Despite the need for incontinence supplies like adult diapers among those who have urinary or bowel incontinence, these products are typically not covered under traditional Medicare. However, some insurers offer specific Medicare Part C plans that may cover at least some benefits, but they are not available in all areas.
Medicare enrollees who are part of the Program of All-Inclusive Care for the Elderly (PACE), a program associated with Medicare and Medicaid, may be able to receive a benefit for incontinence supplies. The program aims to help elderly and frail individuals receive the care they need from their communities rather than in nursing homes or other long-term facilities.
If you are interested in finding a Medicare plan that will help you pay for incontinence supplies, Medicare Advantage plans are your best option. Be sure to take the time to review the plans to find out whether adult diapers and other incontinence products are covered.
What Is Medicaid and Who Qualifies?
Medicaid is a public health program run by individual states that is designed for individuals who fall below specific income guidelines or who have certain disabilities that prevent them from earning enough income to afford health insurance on their own. More than 83 million people were covered under Medicaid programs in 2024. Like Medicare, Medicaid is available from a variety of insurers from state to state, and individuals usually have more than one plan from which to choose.
It is important to note that individuals who qualify for or who already have Medicare may also qualify for Medicaid. In this case, Medicare serves as the primary plan, and Medicaid steps in to provide coverage for many things that Medicare will not. Furthermore, because incomes and the cost of living from state to state varies significantly, the individual states determine the qualification guidelines.
Does Medicaid Cover Incontinence Products?
Fortunately for those who qualify for Medicaid, most states and most plans will cover at least some of the costs associated with incontinence products. States must provide this coverage to children older than 3 and younger than 21 who have developmental delays or cerebral palsy, but they are not required to provide incontinence products to adults over the age of 21. As of 2024, only three states – Alabama, Georgia, and Louisiana – do not provide incontinence product benefits to Medicaid enrollees over 21.
All other states have at least one plan that covers some of the cost of incontinence supplies, but the number of units allowed per month can vary. Some of the products that Medicaid may cover include adult diapers, barrier creams for the skin, and disposable wipes. Does Medicare cover incontinence products? No, but Medicaid usually does, so if you are struggling to pay for your supplies, find out if you qualify – even if you already have Medicare.
How to Get Medicaid Incontinence Supplies
Most of the time, if you want to have some or all of the cost of your incontinence supplies covered by Medicaid, you will need to obtain a prescription or prior authorization from a healthcare provider, along with a diagnosis that qualifies you for the benefit. These documents tell the insurance company about your condition and why you need the supplies, and some states may require your health provider to estimate the number of supplies you will need each month.
Once approved, your state may require you to order your products through specific suppliers with whom they have partnership. Other states may allow you to choose the supplier of your choice as long as you stay under the product limit and within the budget.
What If You Don’t Qualify for Medicaid?
If you do not qualify for Medicaid and you are struggling to pay for your incontinence products on your own, there may be options available in your local area. For example, if you are a veteran of the U.S. Armed Forces, or if you are (or are a family member of) an active servicemember, you may qualify for a special benefit that covers incontinence supplies.
The National Diaper Bank Network is another helpful resource that can help you find local diaper banks that may be able to provide supplies. Otherwise, you can call 2-1-1 for free from any phone to learn more about local agencies that may be able to help.
Making Incontinence Supplies Affordable and Sustainable
Although Medicare does not usually cover the cost of incontinence products, its associated PACE program often does. Furthermore, most people who qualify for Medicaid can receive incontinence product benefits that help pay for these supplies.UnderX offers all the products you need to stay fresh and dry all day, from adult pull-ups to tabbed diapers to balms, wipes, and more. We believe everyone has a right to their dignity and confidence, and incontinence shouldn’t stop you from living your life to the fullest.