Although surgical procedures have come a long way in preventing and treating conditions that were once life-threatening, there are still limitations as to how systems can be re-organized within the body after surgery. In many cases, an ostomy will need to be performed in order to allow for waste products to be re-routed away from traditional elimination channels, requiring patients who have undergone an ostomy to rely on things like pouches, tubing and ports that may be utilized temporarily or permanently to allow for continued and improved quality of life and proper and hygienic waste disposal.
When is an Ostomy Necessary?
An ostomy usually takes place when tissue has been removed from a system in the body that handles digestion and the processing of food, chemicals and waste. This may mean things like intestines, but an ostomy may also be necessary when the bladder or certain biliary functions have been affected by surgery. Surgery requiring an ostomy can have a number of different causes, including cell death caused by cancer or tissue removal to stop the spread of cancer to other parts of the body.
After an ostomy is completed, a patient will usually continue to process waste in the same manner as before the surgery, but instead of eliminating waste naturally, waste will be routed through tubing to collection pouches that will need to be emptied or disposed of. Most such pouches can be discreetly carried with a patient, providing the ability to take part in daily activities with limited disruption. Modern materials allow for these materials to remain cleaner than ever before, but because of the nature of waste produced by the body, ostomy supplies will need to be cleaned or replaced on a regular basis to avoid complications like infection or damage to nearby organs.
New supplies can typically be purchased through suppliers in weekly or monthly quantities, but some may also be available through a specialist’s office. When using ostomy supplies for the first time, you will need to work with a trained professional who will provide you with instructions regarding care, cleaning, disposal and replacement of ostomy supplies.
Does Medicare Cover Ostomy Supplies?
Medicare insurance usually provides coverage for ostomy surgery and supplies required for maintenance through Part B. Medicare Part B, or Medical Insurance, helps cover outpatient treatment on a temporary or continual basis. Although Medicare Part D offers coverage for medical prescriptions that may need to be taken after an ostomy surgery, Part D does not cover physical supplies, even if they are technically considered to be prescribed, because they are not actual drugs that can be purchased at a retail pharmacy.
Medicare may also provide benefits for recipients who require rehabilitation and associated care in a skilled nursing facility after an ostomy procedure. During this stay, Medicare Part A provides coverage for most treatments, meaning supplies that are utilized or ports that are placed during the stay could qualify under Part A instead of Part B.
If you’re a Medicare insurance recipient, it would be beneficial to discuss your needs with your physician prior to undergoing ostomy surgery when possible. This will allow you to discover what options are available in your area and whether you can order ostomy supplies online and still have them covered. Your choice of ostomy product manufacturer may make a difference in whether or not your preferred supplies are covered or not, but there are many options available.