With Medicare’s ever-changing guidelines for coverage and reimbursement, people have trouble knowing about catheters coverage through Medicare. This is particularly evident in urinary incontinence products, given the wide variety of catheters available. Aeroflow Healthcare aims to be not only your supplier for all your catheter and incontinence needs but also your source of reliable and relatable information for you to make an informed decision.
What Does Medicare Cover for Catheters?
|Catheter Type||Medicare Coverage|
|External Catheter||up to 35/month|
|Intermittent Catheter||up to 200/month|
Intermittent Catheter through Medicare
Broadly, Medicare covers 200 intermittent single-use catheters each month. Beyond the normal straight tip, these can also include Coude tip catheters, depending on the patient’s individual needs and preferences. For the Coude tip type of catheter, a medical need or barrier to using a straight tip catheter must be demonstrated in order for Medicare to cover the Coude tip. This allotment allows patients to change their catheter at least 6 times a day. Patients still have extra catheters should any difficulties with insertion arise.
One of the greatest barriers to regular catheter use is the discomfort of insertion. For this reason, Aeroflow recommends a hydrophilic catheter through Medicare. Hydrophilic catheters decrease the possibility of failed insertions because of a sterile saline lubrication. The sterile saline lubrication decreases the possibility of failed insertions. By eliminating barriers to reliable and regular catheterization, patients will experience an increase in the effectiveness of their treatment and their quality of life.
Aside from standard intermittent catheters, Medicare will also cover 1 indwelling catheter, or Foley catheter, each month. A Coude tip version of the indwelling or Foley catheter is also available, provided patients can demonstrate a medical necessity for this variation.
Additionally, Medicare covers up to 35 external catheters for men.
Closed Catheter System
One of the most common questions relating to catheterization is the ability to utilize a closed catheter system. Medicare provides a closed catheter system if the patient meets the strict criteria.
Most commonly, a patient will have had recurrent urinary tract infections while on a program of sterile intermittent catheterization, twice within the 12 months prior to the initiation of sterile intermittent catheter kits.
Additionally, patients in nursing facilities or immunosuppressed patients can qualify for a closed catheter system. Finally, patients with vesicoureteral reflux while on a program of intermittent catheterization or pregnant spinal cord injured females with neurogenic bladder would also be able to utilize such a system under Medicare’s guidelines.
Incontinence Products through Medicare
Finally, Medicare provides for more than just strictly catheter needs when it comes to catheter supplies and incontinence products. Medicare will also cover a variety of irrigation kits, bedside drain bags, leg bags, irrigation syringes, and extension tubing. For indwelling and Foley catheters, Medicare will also provide various administration and sanitation products such as:
- cath strips
- leg straps
- anchor devices
As you can see, there is a wide variety of incontinence products. When choosing what is right for your personal medical needs, trust Aeroflow Healthcare to be with you every step of the way. Qualify for your catheter supplies to be covered by insurance today.