Original Medicare does not cover incontinence supplies like adult diapers.
Some Medicare Advantage plans help pay for incontinence supplies through an over-the-counter stipend.
Medicaid may help pay for incontinence supplies like adult diapers. Individuals not on Medicaid but with limited resources may be able to get assistance from community support programs.
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The Urology Care Foundation estimates that urinary incontinence impacts at least one-quarter of men and women in the United States. Adult diapers are the most common way to guard against uncomfortable accidents.
Original Medicare may provide coverage only if your incontinence supplies are deemed medically necessary as a part of long-term care.
While Original Medicare doesn’t cover incontinence supplies, some Medicare Advantage plans provide a monthly or quarterly stipend to purchase over-the-counter supplies like adult diapers. Your plan determines if you must order through the Medicare supply catalog.
Medicare Advantage (Part C) combines the benefits of Original Medicare (Parts A and B). Along with including Part A and B benefits, Medicare Part C often bundles additional services like dental, hearing, vision and prescription drug coverage.
Does Medicare cover incontinence supplies?
Medicare does not cover incontinence supplies unless medically necessary. Some Medicare Advantage plans may offer prepaid funds, which you can choose to spend on incontinence supplies.
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Some states’ Medicaid programs may provide coverage for these items. Medicaid requires a doctor’s order that adult diapers are medically necessary.
Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age.
If you’re able to verify income status — i.e. on Medicaid, Food Stamps — you may be able to receive assistance from a community diaper bank designed to deliver these products for free to individuals in need.
If you’re a caregiver for someone with low-income status, you may be able to apply for a caregiver grant, which provides funds that can pay for adult diapers. Options like the National Family Caregiver Support Program may be able to help.
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Part D does not cover incontinence supplies. Typically, if you have Original Medicare Part A and Part B, you can add Part D prescription coverage. Many Medicare Advantage plans include Medicare Part D.
However, some Medicare Advantage plans provide a specific amount of funds that can be used toward an over-the-counter stipend or prepaid debit card. These funds are for your personal care items like toothpaste, aspirin, or incontinence supplies.