Incontinence is a topic that not many people want to bring up, but it happens to a large percentage of individuals. In fact, of those receiving Medicare coverage, about 35 percent of female clients and 25 percent of male clients suffer from it. While it may seem to be difficult to have a conversation about this issue with your physician, it may be beneficial to do so. If you do suffer from incontinence, the use of adult diapers, such as Depends, and other incontinence supplies is common. While Medicare insurance does not cover these supplies themselves in many cases, you may still be able to get treatment to address the underlying cause of this problem.
What is Incontinence?
Incontinence is described as a loss of bladder control, and it can occur for a variety of reasons. This issue can be embarrassing and affect quality of life for those who have been diagnosed with it. Incontinence does become more prevalent with age, but that doesn’t mean that it is guaranteed to happen. Additionally, the underlying cause can vary and may be treatable in some instances.
There are five main types of incontinence:
This issue is not caused by mental stress, but instead results from extra stress and pressure on the bladder. This stress can result from being overweight, pregnancy, laughing, exercise, sneezing, moving around heavy objects, and more.
Urge incontinence, also known as overactive bladder incontinence, happens when the nerves or muscles surrounding the bladder are damaged. This can result in urgent needs to go to the bathroom and may not give you enough time to make it. This issue can occur due to a variety of health conditions, including Parkinson’s disease, diabetes, multiple sclerosis, or a stroke.
Overflow incontinence is most common in men and occurs when you have difficulty fully emptying your bladder. This results in the bladder overfilling and leaking out as a result. It can be caused by an enlarged prostate, the presence of a tumor, nerve damage, constipation, medications, or weak bladder muscles.
Functional incontinence occurs due to physical or mental impairments and is commonly seen with severe arthritis, dementia, and Alzheimer’s disease. Each of these conditions can affect a person’s ability to make it to the bathroom quickly and can result in incontinence issues.
Mixed incontinence occurs when two or more other types of incontinence affect a person simultaneously. This is most often seen in women, and the most common combination is urge and stress incontinence.
Does Medicare Cover Depends?
Medicare coverage often does not provide financial relief for incontinence supplies, such as Depends or other adult diapers, pads, and more. Medicare Supplement plans also do not provide coverage for these supplies. However, there are a few different ways and circumstances in which Medicare may provide some coverage for these items.
If you end up requiring care as an inpatient in a hospital facility, all the supplies you require during your stay will be covered by Medicare Part A. Additionally, if you are staying in a skilled nursing facility and your care is being covered by insurance, your supplies will be covered as well.
If you do suffer from incontinence, visiting your physician could be a beneficial way to learn more about your specific condition. As long as you visit a Medicare-approved facility and use an approved provider who accepts assignment, your office visit and all associated tests may be covered by Medicare. The results of these tests could provide insight as to the underlying cause of your incontinence and allow your healthcare provider to offer medication or other treatments to address the problem directly.
If you visit your physician, Medicare will most likely require you to pay 20 percent of the Medicare-approved amount of the treatment in addition to any copayments, deductibles, or premiums you plan includes. Also, if you qualify for Medicaid, you may be able to receive additional coverage for these supplies.
If you are enrolled in a Medicare Advantage plan, you will have at least the same Part A and Part B coverage as Original Medicare, but many Medicare Advantage plans provide additional benefits. Check with your plan directly to find out what benefits may help you treat incontinence.