Living with incontinence can be difficult. Whether it’s bladder or bowel leakage, many people struggle in silence, unsure where to turn or whether help is even available. The truth is, incontinence is a medical condition, not a personal problem, and millions of Americans deal with it every day.

One of the most common questions that comes up when discussing incontinence and what you need is: “Will insurance cover incontinence supplies?” The answer depends on your insurance plan, but for most individuals, or about 90-95%, coverage is available. Here’s everything you need to know.

Who is Affected by Incontinence?

Incontinence affects millions of people of all ages, backgrounds, and activity levels. While it is more common in women, many times after childbirth, during menopause, and with ageing, it can affect anyone. Hormonal changes and strain on pelvic muscles often contribute to bladder control issues, but these factors are not exclusive.

Men over 60 are also commonly affected. Incontinence is frequently associated with prostate conditions or treatments. Additionally, people living with chronic health conditions such as diabetes, obesity, and neurological disorders, including multiple sclerosis, Parkinson’s disease, and stroke, are at increased risk. 

What Are Typical Incontinence Supplies People Need?

Incontinence supplies vary based on the type and severity of leakage. Common products include absorbent pads and liners for light leakage, protective underwear or pull-ups for moderate incontinence, and adult briefs or diapers for heavier or overnight protection. Many people also use underpads, called chux, to protect beds, furniture, and wheelchairs.

Skin care products such as cleansing wipes, barrier creams, and protective ointments are important for maintaining skin health and preventing irritation. Disposal bags are also commonly used to support hygiene and discreet cleanup.

Will Medical Insurance Cover Incontinence Supplies?

So, what insurance covers incontinence supplies? The answer depends on the type of insurance and whether the supplies are considered medically necessary. In some cases, insurance will cover incontinence products when a healthcare provider determines they are required to manage a diagnosed medical condition. You’ll need to:

  • Confirm insurance coverage
      1. Call the number on the back of your insurance card.
      2. Ask to speak with a benefits specialist and request a Declaration of Covered Benefits.
  • Get a Letter of Medical Necessity
      1. Contact your treating provider, urologist, or neurologist. Request a Letter of Medical Necessity (LMN) that includes the following:
        1. Your full name, date of birth, and diagnosis
        2. Diagnosis Code(s) (ICD-10, such as N31.9 (Neurogenic Bladder}, or R32 (Unspecified Urinary Incontinence)
        3. Description of incontinence severity
        4. Quantity of supplies needed per day/month
        5. Type of supplies needed, including brand, model and HCPCS codes
  • Find a Supplier
      1. Many private insurers have a limited range of in-network Durable Medical Equipment (DME) suppliers that carry adult incontinence products, especially high-absorbency ones.
  • Preauthorization (if required)
      1. Some insurance plans require preauthorization before they approve any claims for medical supplies.
  • File the Insurance Claim (Neb Medical will file on your behalf)
    1. If you qualify, Neb Medical will file a claim through your insurer’s Member Portal or by mail. 

Otherwise, you can see if you qualify here.

Medicaid is the most common insurance program that covers incontinence supplies. With a doctor’s prescription and documentation of medical necessity, Medicaid may provide products such as adult diapers, pull-on underwear, and absorbent pads at little or no cost. Medicare and most private insurance plans generally do not cover disposable incontinence supplies, although some private plans may offer limited coverage or reimbursement.

Qualifying Through Your Insurance With Neb Medical Services

At the end of the day, most people dealing with incontinence are unaware that their insurance may help cover the cost of necessary incontinence supplies. Neb Medical Services works with patients to determine eligibility and simplify the process. 

As a convenient, in-network provider for many major health insurers, Neb Medical Services allows patients to select the products they need while handling insurance verification and billing on their behalf – making access to essential incontinence supplies easier, more affordable, and stress-free.

See if You Qualify – Order Incontinence and Mobility Supplies Covered by Insurance