Diaper and Incontinence Product Coverage Through Medicaid

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WHO CAN GET DIAPERS AND HOW TO GET THEM

 

The state of Florida states that payment will only be made for treatment of a diagnosed medical condition, so diapers can only be prescribed for children who remain incontinent beyond the typical age of potty training. The state of Florida states that they begin covering diapers at age  four. 

The process for getting diapers typically requires several components:

  • Obtain a detailed prescription or letter of medical necessity from your child’s doctor, which may include your child’s main diagnosis, a diagnosis of incontinence, an estimated duration of the condition, and the amount of supplies needed per month.
  • Obtain prior approval for the items from Medicaid.
  • Contact Horizons Medical Supplies and Homecare, LLC to provide the items.

Horizons Medical Supplies and Homecare will obtain the physician’s prescription and Medicaid approval.

The medicaid plan will cover briefs, pull-ups, underpads (chux), skin barriers and wipes.  

PRIVATE INSURANCE

 Private insurance plans are not required to offer comprehensive benefits, and most do not cover diapers or other incontinence supplies. Nonetheless, it is worthwhile to try to use a vendor who will attempt to bill your private insurance, because you may be surprised to find the supplies approved. One parent had the experience of her private insurance sending out a denial letter stating the policy did not cover incontinence supplies; however, when the insurance company was billed for the supplies under standard medical supply codes, the items were covered and paid for. 

THE MORAL OF THE STORY

Diapers are covered for every child with diagnosed incontinence who is past the potty training age, as long as the child has Medicaid. Private insurance plans vary and may or may not cover diapers. Hopefully this information can help families obtain diaper coverage and save a little bit of money each month! 


FOR MORE DETAILS

Please contact Horizons Medical Supplies and Homecare, LLC

at (407) 240-8600 or visit us at 170. S. Semoran Blvd, Orlando Fl, 32807