Original Medicare, which is known as Medicare Part A and Part B, does not generally cover adult diapers other than in a long-term care facility. Other Medicare parts may help with coverage and costs.

While Medicare may not cover the cost of incontinence products, such as adult diapers, it typically covers many of the costs of determining the cause.

This article examines Medicare coverage, the cost of adult diapers, and possible financial help that may be available. It also discusses the causes, diagnosis, and treatments of adult urinary incontinence.

Medicare is a federal health insurance program with various parts. Each part covers different services.

Part A provides hospital coverage, which includes inpatient care such as hospital stays.

Part B is medical insurance. It pays for tests to help find the cause of incontinence, but it does not cover adult diapers as they do not qualify as durable medical equipment.

Part C, known as Medicare Advantage, provides the same coverage as Original Medicare, alongside certain other benefits. Although most Medicare Advantage plans do not cover adult diapers, some offer coverage for over-the-counter supplies, including adult diapers. A person can check with their plan provider for coverage details.

Part D covers prescription drugs. It does not cover the cost of adult diapers. However, discount prescription drug cards may cover certain medical supplies, such as adult diapers.

Medicaid is a state and federally-funded program that provides health coverage to people with limited incomes or disabilities.

The federal government sets mandatory benefits that every state Medicaid program must cover, and each state sets the rules about optional benefits.

Medicaid will pay for adult diapers if they are medically necessary. If they are not, the person may have to pay 100% of the cost out of pocket.

In most states, Medicaid covers adult diapers, though the amount varies. A person can contact their state Medicaid office to ask for assistance paying for adult diapers.

There are several programs that may help with the cost of adult diapers.

The Medicaid waiver program can help community-based services provide help to people who might otherwise be in a long-term care facility. Each state may operate the program differently. People can contact their state’s Medicaid office to check their eligibility.

Some communities also have diaper banks that provide diapers and other supplies to people with limited incomes. In many cases, adult diapers are free, though each group has specific policies about products, services, and distribution.

Also, some families may qualify for a National Family Caregiver Support Program grant, which helps families caring for older adults. The Department of Health and Human Resources in a person’s state will set the eligibility requirements.

Discount prescription drug cards may also cover medical supplies.

Urinary incontinence is the medical term for accidental leakage of urine from the bladder. Persistent contact with urine can cause skin damage, and wetness may cause swelling and skin breakdown. This, in turn, can lead to chronic wounds.

Urinary incontinence tends to affectTrusted Source women more than men.

How does the bladder work?

The bladder storesTrusted Source urine until it gets a signal from the brain to empty. Sphincter muscles control whether the bladder is closed or open. When the bladder is closed, the sphincter muscles are also closed around the tube, called the urethra, that allows urine to exit the body.

When a person is ready to urinate, a signal goes from the brain to the bladder, which contracts and allows the urine to exit through the urethra.

People may be able to control urine leakage with medication or physical therapy.

Possible causes of incontinence

There are several reasons that the bladder may leak urine, including:

Additionally, after someone has a stroke or if they have diabetes, dementia, or Parkinson’s disease, they may feel a sudden urge to urinate. However, they cannot reach the toilet in time to prevent leakage.

To diagnose the condition, a healthcare professional will perform a physical exam, take a person’s medical history, and perform urine and blood tests. Some people may also need admittance to the hospital.

A person’s primary care physician may also ask them to speak with a urologist. These are doctors who specialize in treating issues affecting the urinary tract.

There are several treatmentsTrusted Source that a healthcare professional may prescribe, depending on the cause of the condition, its severity, and a person’s lifestyle.

Treatments may include:

  • training the bladder so that a person has more control over it, such as by using biofeedback sensors or performing pelvic muscle exercises
  • making certain changes to lifestyle, such as quitting or avoiding smoking, maintaining a moderate weight, or changing the diet
  • practicing timed voiding on a set schedule, such as every hour

Various health conditions can cause urinary incontinence. Medicare Part B will pay for tests to determine the cause of the incontinence, but it does not pay for adult diapers. However, some Medicare Advantage plans may offer coverage.

Other resources to help pay for adult diapers include Medicaid, diaper banks, certain grants, and prescription drug cards.

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Resources:

Leslie SW, et al. (2024). Urinary incontinence. https://www.ncbi.nlm.nih.gov/books/NBK559095/Trusted Source

McNichol LL, et al. (2018). Incontinence-associated dermatitis: State of the science and knowledge translation. https://journals.lww.com/aswcjournal/fulltext/2018/11000/incontinence_associated_dermatitis__state_of_the.4.aspx