My Medicaid Insurance Doesn’t Cover The Incontinence Products I Want To Use: What Are My Options?

Question: My Medicaid incontinence benefits (or other insurance plan) do not provide coverage for the incontinence care products I wish to use. Do I have any other options?

Answer:

While Medicaid serves over 76 million Americans in need with vital healthcare supplies and services, it is important to understand that each of the 50 states administers Medicaid benefits under its own rules and guidelines. This means that it may be easier or more difficult to get different types or brands of medically necessary supplies, including incontinence care products, depending on where you live.

Once you have determined your Medicaid eligibility (utilizing Medicaid.gov,  Healthcare.gov or the Health Insurance Marketplace), you may find that the particular incontinence products you wish to use are not covered or are not carried by a Medicaid supply provider in your area. You may be required to order lower-quality items than you are accustomed to using, or brands that lack the product features you seek.

If you are in this situation, here are a few suggestions you can try out.

For one, if you do not see the brand that you want offered by your supply provider, call them and ask if they can begin to offer that brand. You may also want to search online for a new product dealer in your area or a web-based supplier that delivers to your area, which carries your brand. 

If you are unable to find a dealer offering your preferred brand, you may have to use a product in another brand that lacks the absorbent capacity you require. In that case, here’s a possible solution: try adding a booster pad. If you are unfamiliar with a booster pad, it’s worn inside another disposable incontinence garment (tape-tab brief or pull-on underwear). Boosters are designed to absorb a certain amount of fluid before allowing excess fluid to pass through* to the other disposable product. This adds extra capacity, helping to avoid leaks and allowing you to go longer in between changes.

And the great news is – booster pads may be covered under your state’s Medicaid incontinence benefit, meaning you can get the combination of products that provide the protection you need, at no cost to you.

If you are unhappy with the incontinence products you are receiving through your Medicaid benefit, Tranquility® may be able to help. Our team will work with you and your family to navigate the Medicaid guidelines in your state and locate a Medicaid incontinence supply provider in your area. 

Contact us today to get started.