Does Medicare cover incontinence supplies?

Original Medicare does not cover incontinence supplies, but may cover doctor visits and tests your doctor orders to check bladder or bowel control problems. If you need treatment, it may also cover medically necessary care, like specialist visits or outpatient physical therapy. The goal is to find what’s causing the leaks and help you treat it.

If you have new or worsening leaks, tell your doctor. They can look for the cause and help you choose a treatment plan.

Your doctor may ask when leaks happen, what you drink or eat, and what medicines you take. They may do an exam or order tests to check for issues like an infection or medicine side effects.

Some bladder changes can happen as you age. Your doctor may suggest pelvic floor physical therapy, which can help strengthen the muscles that support your bladder. If your doctor says it’s medically necessary, Part B may help cover outpatient physical therapy.
 

Find doctors, specialists and therapists covered by your plan

What you pay depends on where you get care and what type of coverage for incontinence supplies you have.
 

Learn about the different parts of Medicare

Medicare classifies most adult diapers, disposable pads, liners, briefs and protective underwear as personal care items, not medical supplies. That means you pay 100% for items you buy at a store or online.

Paying out of pocket can add up, especially if you use these items every day. To estimate your costs, track what you use for one week. Then use that number to plan what you may need for the month.

To help stretch your budget, look for store brands, coupons and sales. If you have space, buying in bulk may lower the cost per item. Planning ahead can also help you avoid last-minute trips.

Original Medicare does not cover the following products:
 

• Adult diapers such as Depends, disposable briefs and protective underwear
• Disposable pads, panty liners and liners
• Disposable underpads (often called bed pads)

You may also see wipes, skin cream and bed sheet pads sold with these items. Original Medicare also doesn’t pay for most items that are just for comfort or day-to-day care such as adult diapers.  

Catheters and some other urology supplies are not the same as diapers or pads. These items may be part of medical care for some bladder issues.

If your doctor orders a catheter for home use and you meet Medicare rules, Part B may cover it as durable medical equipment (DME). You need a doctor’s order, and you may need to use a supplier that takes Medicare.

When Medicare covers DME, you pay your Part B deductible first. After that, you pay 20% of the approved amount if your supplier accepts assignment. You may pay more if your supplier doesn’t accept assignment.

Your doctor can write the order and help explain why you need the supply. Learn more about Medicare coverage for durable medical equipment.  

Many Medicare Advantage plans include added benefits beyond Original Medicare. But added benefits can vary by plan and where you live, so you need to check what your plan includes.

Some plans may give an over-the-counter (OTC) benefit amount (allowance) to help pay for certain everyday health and wellness products, including some incontinence products. Other plans may not offer help for adult diapers, pads or liners. That’s why it helps to check before you buy.

Start with your Evidence of Coverage and Summary of Benefits. Look for information about the OTC benefit, limits and any rules on where you can shop. If you don’t see clear info, call Member Services and ask about adult diapers or pads.

When you call, ask if you need to use a certain store, mail order or a set list of products. Also ask about the allowance amount for each month or quarter.

If your plan includes an OTC allowance, check your balance and the approved product list before you order or shop.

Are you a member? Review your plan coverage and benefits, including OTC details.
 

Not a member? Explore Medicare Advantage plans.