Does Medicare Cover Incontinence Supplies?
Key takeaways:
Original Medicare doesn’t cover adult diapers and other absorbent incontinence supplies. But your Medicare Advantage plan may cover them.
If you are diagnosed with permanent urinary incontinence or permanent urinary retention, original Medicare may cover urological items such as urinary catheters and external urinary collection devices.
If you can’t afford adult diapers or other absorbent incontinence supplies, you may be able to get these items for free or at a low cost through diaper banks, food banks, and other community organizations.
Table of contents
Urinary incontinence is involuntary leakage from the bladder. This condition can happen to anyone at any age, but it is most common in women over age 50 and seniors. Urinary incontinence can range from occasional leaks to no ability to hold urine.
This story will focus on urinary incontinence supplies. However, people can also experience fecal incontinence, which is the inability to control the passage of gas or stool.
What is urinary incontinence?
Urinary incontinence is the accidental loss of urine. About 50% of women will experience some kind of urinary incontinence during their lifetimes. This is typically caused by pregnancies and childbirth as well as hormonal changes during menopause.
Prescription Savings Are Just the Beginning
See what other benefits you qualify for—from cashback cards to cheaper insurance.
Some types of urinary incontinence include:
Stress incontinence: Leaks happen during movement such as exercise or when you cough, sneeze, or laugh.
Urgency incontinence: You feel a strong urge to urinate, but you can’t hold the urine long enough to make it to the bathroom. This condition can be caused by an overactive bladder.
Functional incontinence: Your urine leaks because your arthritis, injury, disability, or other condition prevents you from getting to the bathroom in time.
Overflow incontinence: Your bladder doesn’t empty completely, so you experience leaks and dribbling when the amount of urine exceeds the bladder’s capacity.
What incontinence supplies are available?
Urinary incontinence products include disposable and reusable:
Adult diapers or briefs
Bladder control inserts
Bladder control pads
Protective underwear, also known as pull-ons
There are some incontinence products specifically designed for female and male anatomy.
Female anatomy
Disposable vaginal insert: This device is inserted into the vagina like a tampon to place pressure on the urethra (the tube that lets urine leave your bladder) and prevent leaks.
Pessaries: These are reusable devices inserted in your vagina that support your bladder and place pressure on your urethra to prevent leaks. Your healthcare professional must prescribe and fit a pessary.
Urethra cap: This reusable silicone shield is placed over your urethral opening.
Urethral insert: This is a soft plastic balloon that is inserted into your urethra. It blocks urine from leaking.
Wicking devices: These external catheters draw or suction urine away from people with a vagina into a collection canister to keep the person dry. These devices are typically used while the person is in one place for an extended period, such as while reclining or during sleep.
Male anatomy
Condom catheter: This device is placed over the penis like a condom and has a collection bag tied to the leg that can receive small and large amounts of urine.
Cunningham clamp: This reusable device is placed over the penis and keeps the urethra closed until you empty your bladder.
Drip collector: This is a small pocket of absorbent padding for constant small leaks. This device is worn over the penis with close-fitting underwear.
Read more like this
Explore these related articles, suggested for readers like you.
What incontinence supplies are not covered by Medicare?
Original Medicare doesn’t cover adult diapers or other absorbent incontinence supplies for any condition. These items are considered disposable personal hygiene products and not medical treatment. However, they may be covered by certain Medicare Advantage plans, such as this one, as an over-the-counter benefit.
What nonabsorbent urological supplies are covered by Medicare?
Medicare Part B or your Medicare Advantage plan may cover certain nonabsorbent urological supplies as durable medical equipment if you are diagnosed with permanent urinary incontinence or permanent urinary retention. These urological supplies are alternatives to incontinence products.
These items include urinary catheters, such as condom catheters and indwelling catheters, as well as external urinary collection devices. If you have one of these devices, some associated supplies also will be covered.
Your coverage for urological supplies will depend on you:
Having a diagnosis of permanent urinary incontinence or permanent urinary retention
Getting a prescription from your healthcare professional
Ordering covered products with a Medicare-approved supplier
How can you get free or low-cost incontinence supplies?
If you have Medicaid — or have Medicare and full Medicaid, known as dually eligible — your incontinence supplies may be covered. Most Medicaid programs will cover incontinence and bladder-control products for adults, but states and territories are not required to offer this benefit. You will need a diagnosed condition causing incontinence to access these products as a necessary medical supply.
Diaper banks, food banks, and other community organizations give away free diapers for children and may keep incontinence supplies like adult diapers in stock. Contact groups in your area to learn about their eligibility requirements and what resources they can provide.
The National Association for Continence offers lists of incontinence products and savings offers from their partners on items for people with male anatomy and female anatomy.
Alleged Medicare catheter fraud
At publication time, the FBI, federal lawmakers, and other officials were investigating an alleged $2 billion Medicare billing scheme associated with urinary catheters used to treat incontinence. If you order catheters covered by Medicare, make sure you are dealing with a reputable supplier and that you receive the items you have ordered.
Federal officials are warning Medicare enrollees to avoid sharing their personal information with people who contact you and claim you are eligible for Medicare-covered items for free or at no cost. Once scammers have enough of your information, they will bill Medicare for medically unnecessary urinary catheters or other items on your behalf that may or may not be sent to you.
The bottom line
Original Medicare doesn’t cover adult diapers or other absorbent incontinence supplies, but your Medicare Advantage plan might offer these benefits. Medicare Part B will cover certain urological products and supplies if you are diagnosed with permanent urinary incontinence or permanent urinary retention. Your Medicare Advantage plan will meet or exceed these benefits.
If you have Medicaid or you are dually eligible and have Medicare with full Medicaid, your incontinence supplies may be covered by your state or territory Medicaid program.
If you need incontinence products that aren’t covered and can’t afford them, you may be able to access free or low-cost adult diapers and other supplies from diaper banks, food banks, and other community organizations in your area.
Why trust our experts?
References
Blue Cross Blue Shield of Michigan. (2023). Adult diapers and incontinence liners.
CMS.gov. (n.d.). Urological supplies.
CMS.gov. (n.d.). Urological supplies – policy article.
Diamond, D. (2024). GOP leaders demand answers from Medicare on alleged $2B catheter fraud. The Washington Post.
Home Care Delivered. (n.d.). What is a condom catheter?
Johns Hopkins Medicine. (n.d.). Urinary incontinence.
Johns Hopkins Medicine. (n.d.). Urinary incontinence in women.
Malzone, L. (2023). Medicare coverage for incontinence supplies. Medigap.
Medicare.gov. (n.d.). Incontinence supplies and adult diapers.
Medicare.gov. (n.d.). Mandatory and optional Medicaid benefits.
Medicare.gov. (n.d.). Medicaid.
MedlinePlus. (2023). Urinary incontinence products.
MedlinePlus. (2023). Urinary incontinence products – self-care.
National Association for Continence. (n.d.). Female products for urinary incontinence.
National Association for Continence. (n.d.). How to get the best incontinence products covered by Medicaid.
National Association for Continence. (n.d.). Urinary incontinence products for men.
Office of Inspector General. (2024). Consumer alert: Urinary catheter scams. U.S. Department of Health and Human Services.
UChicago Medicine. (n.d.). Urinary incontinence.
Urology Care Foundation. (n.d.). What is urinary incontinence?
