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CHECK YOUR ELIGIBILITY

In 2 easy steps!

From catheters to pediatric and adult bladder control supplies, discover the continence care essentials covered by your insurance.

Have your insurance card ready!

Child's First Name
Child's Last Name
Child's Date of Birth Please provide the date of birth for the person in need of continence care supplies (yourself, your child, etc.)
Date
Phone
State
Zip Code
Child's Insurance Provider Your insurance type is most frequently found at the top of your insurance card.
Name of Insurance Carrier
Member ID Your Member ID is typically found on the front of your insurance card and may be listed as Member ID, Member #, Subscriber ID, Subscriber # or Policy #. This can be a combination of letters and numbers.
Child's Medical Condition In order to receive coverage for continence care supplies, Medicaid requires a diagnosed medical condition related to your child's incontinence.
Name of Child's Medical Condition
Gender
How did you hear about us?
Step 2 of 2

Get You or Your Child Diapers, Pull-Ups, & More With Aeroflow Urology

If you want to find out if you can get diapers, pull-ups, underpads, wipes, and more through insurance, fill out our Eligibility Form! It takes less than 5 minutes. Just make sure you have your insurance card on hand!


If you or your child qualifies, we will...

  • Have one of our expert Continence Care Specialists help you get a required prescription from your or your child's healthcare provider.
  • Send you or your child free product samples so you can find what fits the best.
  • Ship your continence care products straight to your home every month... for free!
  • Send you email or text message reminders when it's time to refill your supplies so you won't ever run out of diapers or pull-ups!

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