Do Aetna Plans Cover Incontinence Supplies for Members?
- Aetna members who have urinary incontinence may be able to use certain plan allowances to buy covered incontinence supplies. Learn more.
Some Aetna Medicare Advantage (Part C) plans may help you pay for or reimburse you for covered incontinence supplies. Not all Medicare Advantage plans, including plans offered by Aetna, cover incontinence supplies or offer a plan allowance or reimbursement for these types of over-the-counter (OTC) items, so it's important to compare the plans that are available where you live.
When Does Aetna Cover Incontinence Supplies?
Some Aetna health insurance plans cover external urinary collection devices and catheters for members who have a diagnosis of permanent urinary incontinence.
Covered supplies can include female pouches and cups and male catheters designed to collect urine.
Plans from Aetna typically do not cover absorbent products such as diapers.
It's important to note that the above does not apply to any allowances for approved OTC items a plan might include.
When Does Aetna Consider Urinary Incontinence Permanent?
This insurance provider defines permanent incontinence as a condition that will not resolve either on its own or with treatment within the next 3 months. Aetna requires documentation of this diagnosis for members to receive coverage for catheters and external urine collection devices.
Does Aetna Limit Coverage for Incontinence Supplies?
Aetna has established a monthly coverage limit for incontinence supplies. The company covers one catheter per month unless the device malfunctions, becomes blocked, causes recurrent infections or comes out accidentally.
In these circumstances, Aetna will cover one additional catheter change.
Members can also receive two bedside drainage bags or urinary leg bags per month, unless medical necessity requires additional collection devices.
Does Aetna Cover the PureWick Urine Collection System?
Aetna does not currently cover PureWick because of the lack of available research about the safety and efficacy of this device.
Do Insurance Providers Cover Adult Diapers?
According to the National Association for Continence, few commercial insurance and Medicare providers cover absorbent pads and adult diapers. Most insurance providers do not consider these items to be medically necessary for the treatment of urinary incontinence.
If you have coverage through Medicaid, however, your state program likely covers these supplies in sizes ranging from child to adult bariatric patients. Review your Medicaid plan documents to determine whether you qualify.
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