If you’re the parent of a special needs child, you know that there can be a lot of extra expenses involved in their care – everything from additional childcare to extra therapy, specialized equipment and more.

However, one thing you shouldn’t have to pay for is diapers.

Many kids with special needs wear diapers long after other kids do, whether they are in a wheelchair or can’t get to the bathroom on their own, or they have cognitive issues that make it difficult for them to become potty trained.

For example, children on the autism spectrum often are late in getting potty trained because changing their routines can be very difficult, meaning that some children with autism can be in diapers from age 3 all the way through the teen years and beyond, depending on the child.

And buying big-kid-sized diapers every single day can become extremely costly.

Luckily, children with autism, as well as Down Syndrome, cerebral palsy and a host of other disabilities, can usually receive free diapers through Medicaid, as long as you have a prescription or a letter from your child’s doctor saying that the diapers are medically necessary.

And what’s even better is the process of getting the diapers delivered directly to your door is super easy.

At Neb Medical Services, we work directly with your insurance to get free diapers delivered right to your home – so you can spend less time worrying about supplies and more time caring for your child. And if you’re not sure where to start, we offer a free eligibility check and can even send a free product sample so you can make sure the fit and feel are right before committing. Just give us a call and we’ll walk you through every step.

How to know if your special needs child qualifies for free diapers?

 

Here are the 6 typical requirements to qualify for free diapers if your child as special needs:

  1. Your child must be age 4 or older and have incontinence or not be potty trained due to an underlying medical condition such as autism, Down syndrome, etc.
  2. You must have a letter of medical necessity or a prescription for your pediatrician.
  3. You must have an accurate record of diagnostic information pertaining to the underlying condition, as well as any other medical diagnoses.
  4. Must have the number of times per day your child’s pediatrician has ordered the incontinence supplies to be used.
  5. Must have the number of disposable incontinence supplies requested per month.
  6. If your pediatrician updates your child’s clinical notes to allow you to receive up to 12 months of diapers at a time, you can have all of the diapers delivered at once.

Once you have that information, just call us or another medical supply provider and we can contact your insurance company for you. Then the products can simply be shipped to you, free of charge.

What Medical Conditions Qualify for Free Diapers?

Autism, Down syndrome and cerebral palsy are some of the most common conditions people ask about, but they’re far from the only ones that qualify. Because every child is different, coverage is based on medical necessity rather than a single diagnosis, which means a wide range of conditions may qualify your child for free diapers.

Here are some of the conditions that often qualify:

  • Autism spectrum disorder
  • Down syndrome
  • Cerebral palsy
  • Spina bifida
  • Epilepsy
  • Neurogenic bladder
  • Overactive bladder
  • Hirschsprung’s Disease
  • Crohn’s Disease
  • Intellectual or developmental delays
  • ADHD
  • PTSD

If your child has a condition that isn’t listed here but causes incontinence or makes potty training difficult, don’t assume they won’t qualify. The best thing to do is talk with your pediatrician and reach out to us for a free eligibility check – we’re happy to look into your specific situation for you.

Understanding the EPSDT Medicaid Benefit

If your child is covered by Medicaid, there’s an important benefit you should know about called EPSDT, which stands for Early and Periodic Screening, Diagnostic, and Treatment.

EPSDT is a Medicaid benefit specifically for children and adolescents under the age of 21. In simple terms, it requires Medicaid to cover services and supplies that are medically necessary to treat a child’s condition – even in cases where those same items might not be covered for adults.

For families of special needs children, this often means that incontinence supplies like diapers, pull-ups, underpads and wipes can be covered under EPSDT when a doctor determines they’re medically necessary. It’s one of the main reasons so many special needs children are able to receive their diapers at no cost through Medicaid.

If you’re unsure whether your child’s Medicaid plan includes these supplies under EPSDT, just give us a call. We can contact your plan on your behalf and help you understand exactly what’s covered.

What to Do If Your Special Needs Child Has Private Insurance?

If you don’t qualify for Medicaid and have private insurance instead, you may also be able to have the diapers for your special needs child diapers covered under your insurance plan, but the coverage can vary greatly depending on what type of plan you have, and some plans won’t cover incontinence products at all.

To find out if they’re covered, the easiest thing to do is call us and we can contact your insurance company for you. Often times, private insurance may initially deny a claim for incontinence products, but then will cover it once they have the correct diagnostic code.

What If You Don’t Have Coverage? Diaper Banks Can Help

Not every family qualifies for free diapers through Medicaid or private insurance – and if that’s your situation, please know there are still resources out there to help.

One of the best places to start is the National Diaper Bank Network (NDBN). This organization supports a nationwide community of more than 240 community-based diaper banks, with at least one in every state, plus Washington, D.C. and Puerto Rico. That means no matter where you live, there’s likely a diaper bank within reach that can help provide diapers for your child at no cost.

Diaper banks are a wonderful, judgment-free community resource, and many of them can also connect you with other family support services. To find a diaper bank near you, visit the National Diaper Bank Network’s website and use their locator tool. And remember, using a diaper bank now doesn’t prevent you from also working with us later to see if you qualify for free diapers through insurance – we’re always here to help you explore every option.

How to Find the Right Kind of Incontinence Products for Kids with Special Needs?

Unfortunately, once your kid has aged out of the regular diapers available in the grocery store, it isn’t always easy to find big-kid-sized diapers. One way to do it is to change the word “diaper” to “incontinence products” in your search.

If you get the diapers for free through Medicaid or your insurance, you may only get to choose from certain brands that are covered. However, you may be able to qualify for other types of incontinence products in addition to diapers, depending on what your doctor indicates in the prescription.

Not sure which product is the right fit for your child? We can help with that too. Reach out to us and we’ll be happy to send a free product sample so you can test out the size, feel and absorbency before you receive a full order. It’s an easy, no-pressure way to make sure your child is comfortable.

Here are a few of the things you may be able to get for free, if you need them:

  • Diapers/Briefs

    – Diapers (which are usually referred to as briefs once kids are beyond the toddler stage), have tab closures. That means you can change your child without having to take their pants completely off. These are best for young children, children in wheelchairs or children with limited mobility.If you’re looking for products on your own, Seventh Generation makes diapers that fit kids up to 35 pounds, and Pampers Cruisers can fit kids up to 41 pounds. Tranquility All Through the Night Disposable Briefs are labeled for adults, but the x-small size can fit kids as small as 60 pounds. Once your child is about 58 inches tall and has a waist size of at least 20 inches (roughly around age 11 or 12), he or she should be able to start wear most adult diapers in the smallest size, such as these Medline Adult FitRight Extra Incontinence Briefs.

  • Pull-Ups

    – Unlike diapers, pull-ups don’t have fasteners on the side. Instead, they are disposable underwear that has elastic around the waist and legs to make it easy to pull on or off. They are better for older or more mobile children. Medline’s Youth Underware fits kids as small as 40 pounds, which is the average weight of a 4 year old, and CardinalHealth’s Curity Youth Pants fit kids as small as 38 pounds.

  • Underpads

    – Underpads are used to protect mattresses, beds, car seats or other types of furniture from leaks. They are disposable, so if they get wet, just throw them in trash.

  • Disposable Wipes

    – Disposable wipes are moist towels that can be helpful in cleaning up your child. These from FitRight have a touch of aloe to make it more soothing on your child’s skin.

If you find out your plan doesn’t cover youth diapers, one way to save money on them is to buy in bulk or set up a Flexible Spending Account, which are special, tax-free accounts that you can put money into to pay for medical expenses. The diapers won’t be free, but at least you’ll be able to save up to 30% on them by not having to pay taxes!

Ready to Get Free Diapers Delivered to Your Door?

Caring for a special needs child is a full-time job, and figuring out insurance shouldn’t add to your plate. That’s exactly what we’re here for.

At Neb Medical Services, we’ll handle the hard part – contacting your insurance, confirming your child’s eligibility and coordinating a monthly shipment of free diapers delivered right to your home. And to make things even easier, we’re happy to:

  • Provide a free, no-obligation eligibility check
  • Send a free product sample so you can find the perfect fit
  • Walk you through everything with a free consultation

Every child is different, and we’ll take the time to understand your family’s unique needs. Give us a call today and let’s get started – so you can get back to what matters most.