Insurance

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Got some potentially good news. Sounds like there’s a good chance that they are going to cover my diaper costs.

I don’t know if they’ll let me get a preferred brand or not, I guess it depends on what brands the supplier can get.

I didn’t realize until recently how much I had been spending. I was actually giving myself rashes recently because I wouldn’t be so quick to change because of the cost. Now, I can be healthier and change when necessary.

 

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Lucky Duck!! How did you manage that? I couldn't get BCBS to give me the time of day!!

 

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Negotiate for insurance t cover quality brands maybe reach out to North shore company who have excellent customer service lie you have not seen before excellent and see what their experience is I xassisting getting insurance coverage.
Sorry I respond frequently but I'm on my own email which is what I work from and take short breaks to respond to my personal business.

 

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That's wonderful if you can get insurance to cover the cost of diapers! It's always floored me that they cover all sorts of other costs of medical necessities, but somehow diapers don't count.

 

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It's because diapers are disposable. They only want to cover multi use items!! Cheapskates!!!

 

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So the program is called DME.Durable Medical Equipment. It specifies that disposable diapers ARE NOT covered.

But, I have an incredible case manager who was fired up about this and kept digging and kept working. There’s a program called “Shippy” not sure if I’m spelling it correct and it’s a program to cover costs of things not covered by insurance.

The reality is this only May last while I’m still in the military, but there’s potential that because of all the documentation and the paper trail it “may” convert to when I get out and I’m covered through the VA but that’s not guaranteed.

She said starting out she can get me a 6 month supply, so pretty much I’ll load up and stock pile like crazy, and try to accumulate what I can for now.

It’s one little blessing if it really does get approved.

 

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My insurance only covers really crappy diapers. I figured out a way to make them partially cover MegaMax but I’m still paying $100 a month or more (depending on if I need two or 3 cases). MegaMax is the only thing I can trust

 

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I have TriCare for Life through my husband and would love to have some more info about possible coverage of diapers. I get bad rashes if I don’t change frequently.

 

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Thats great.

 

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@dmorris Tricare doesn’t cover disposable but you could make a case for cloth for sure.

Mine are being covered through a special program to cover costs that aren’t typically covered by Tricare. It probably helps that I am still active.

My guess is it won’t convert once I get medically retired, but the hope is we can manage to get them covered or partially covered because it already is while I’m in, so maybe create some sort of roll over effect.

 

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Hello all. New to this. All of it. I have had stress incontinence for years - am 60 yo female. Have recently within the past six months began experiencing TERRIBLE urge incontinence. Anyway, I am now retired after almost 30 years of Civil Service. I have been trying to find out if my United Healthcare covers incontinence products. Luckily I have always been a "homebody" when I wasn't at work so I'm not as effected as some folks seem to be. Thank God for YouTube!! I stay busy with crafting and such so I am truly blessed. But I can't seem to come to terms with this at all. Been to my Urologist who I've had for years. CT scan shows scattered stones and cysts on both kidneys. Blood in urine is 2 plus. Always has been there. Also another cystoscope. Unremarkable. Who knows why this is happening but I sure don't like it at all. Enough of my complaints just wanted to know if anyone knows about the insurance coverage. God bless all.

 

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I work in health insurance. Most plans do not cover diapers. The only plans that do outside of employer plans with special add one to cover would be Medicaid (Medical Assistance). Medicare does not cover, and plans from the health insurance exchange (healthcare.gov) do not cover. For the product to be covered by medicaid at least in my state, the manufacturer has to submit to the state requesting for their supplies to be included in the covered list. Covered items have a maximum cost that they can be when the start and manufacturer are coming to agreements. You will be hard pressed to find high quality products covered as they cost alot more. I think prevail is one of the commonly covered brands.

 

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Why won't they cover disposable diapers for adults? They are medically necessary in my case and for probably many many others. Is it because they can't be reused. I have even had a couple of my Dr's prescribe them for me. I have submitted the prescription plus documentation and letters from my doctors stating they are medically necessary but they still deny my claim. Have even had it go up the chain in BCBS where they had a committee look at my claim and medical documentation and they still denied it. This is what is wrong with healthcare and medical insurance. You deny claims for products and medicines patients need to life their daily lives. And for me that means diapers for my incontinence. I'll stop my rant but healthcare and health insurance is a bunch of Crap!!

 

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Why won't they cover disposable diapers for adults? They are medically necessary in my case and for probably many many others. Is it because they can't be reused. I have even had a couple of my Dr's prescribe them for me. I have submitted the prescription plus documentation and letters from my doctors stating they are medically necessary but they still deny my claim. Have even had it go up the chain in BCBS where they had a committee look at my claim and medical documentation and they still denied it. This is what is wrong with healthcare and medical insurance. You deny claims for products and medicines patients need to life their daily lives. And for me that means diapers for my incontinence. I'll stop my rant but healthcare and health insurance is a bunch of Crap!!

I looked into this at work today a little bit. The best answer that I was able to come to is that they are considered over the counter and not medically necessary due to the fact they do not treat anything directly. While a stupid reason that is CMS for you.