People With Medicare
Medicare Question of the Month
Each month, our expert showcases a Medicare question submitted by one of our readers. You may submit a question at any time and get a personal response.
This month's question:
My mother lives at an assisted living facility. She is incontinent - will Medicare help pay for the cost of adult diapers?
Urinary incontinence -- the accidental release or loss of bladder control -- is a medical condition that affects millions of Americans. It is common for older adults to have some form of incontinence, which can be brought on by stress, recent surgery, an illness, or other condition. Some people have temporary incontinence. For others, it can become a long-term condition. Your mom should be sure and talk with her doctor to find out the best way to treat or manage it, especially if it’s a long term condition.
As for Medicare coverage, Medicare Part A will cover various medical supplies, but only when you are at a hospital or admitted to a skilled nursing facility under a covered Medicare stay. Medicare has very strict rules about what it covers (and does not cover) under Part B with regard to durable medical equipment (which is the category where incontinence supplies would be considered).
Original (fee-for-service) Medicare does not cover “absorbent” products, such as adult diapers, because they are not considered durable. Medicare does offer limited coverage of "urine collection devices," such as catheters. Some Medicare Advantage plans do cover adult diapers or liners.
To find help with the cost, talk with the Social Services department or the assisted living facility staff or your mom’s doctor. They may be aware of some resources that can possibly help with this expense. In addition, if your mother is eligible, some state Medicaid plans pay for adult diapers.
And, if you are having trouble affording your health supplies, use a web-based screening tool called BenefitsCheckUp to see if you may be eligible for programs that can help pay for health care, housing, food, and more. This tool is completely free and confidential; you can use it at: www.BenefitsCheckUp.org.
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