Coffee & Coverage: Urinary Incontinence and Medicare Coverage

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This article was updated on January 4, 2021.

It can be challenging and expensive to deal with incontinence. It is important to understand the extent of the condition and how to cope with it while still carrying on with your everyday life.

What is incontinence?

Incontinence is a common issue that is experienced more as you age. The condition typically stems from problems with nerves and muscles used to hold and release urine in the bladder. Common signs are leaking urine when you sneeze or cough. Another common sign is feeling the sudden urge to go to the bathroom and not being able to make it in time.

Types of urinary incontinence

While urinary incontinence is fairly common, there are five different types that you can suffer from.

  • Stress incontinence causes urine leaks during coughing, sneezing, exercising, laughing, or anything that constricts your abdominal muscles and applies pressure to your bladder.
  • Urge incontinence is commonly known as overactive bladder and happens when you leak urine after feeling a sudden urge to go to the bathroom.
  • Functional incontinence is when a medical condition keeps you from making it to the bathroom in time.
  • Mixed incontinence is when you suffer from a combination of both stress and urge incontinence.
  • Overflow incontinence is when you struggle to completely empty your bladder. This leads to leaking urine when your bladder is full.

Causes

There are several reasons why people suffer from incontinence, some of which are urinary tract infections (UTIs), constipation, and vaginal infections.

It is not uncommon for medications to cause temporary bladder control issues, but when the issue persists, it could be due to any of the following:

  • Weak bladder muscles
  • Overactive bladder muscles
  • Weak pelvic muscles
  • Prostate issues in men
  • Pelvic organ prolapse
  • Damaged nerves that control the bladder
  • Diseases that can make it difficult to get to the bath¬≠room in time
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What to do

If you are suffering from incontinence, one of the first steps to take is working on your bladder control. Visit your doctor for a full continence assessment if you have concerns about your bladder control. In this assessment, they will look at your current and past medical history along with your diet, exercise, and medication schedule. Your doctor may refer you to a urologist who can look deeper into what is causing the problem. 

Medicare coverage

Original Medicare does not offer coverage for pads or adult diapers for incontinence, which means you pay 100 percent of the costs. However, some Medicare Advantage plans (Part C) may offer coverage. Refer back to your plan to find out if you have incontinence coverage.

Medicare may pay for the costs of tests to find out the cause of incontinence, in which case you would pay 20 percent of the costs while Medicare would pay 80 percent. 

In some cases, Medicare will cover pelvic floor electrical stimulation for stress or urge incontinence. You must have first undergone pelvic muscle exercise training that was not successful. Ask your doctor or urologist for more information.

Ways to get coverage for incontinence

There are options for getting coverage of incontinence supplies, such as:

You may also purchase adult diapers in bulk online. Remember to save your receipts since the cost of adult diapers is tax-deductible.

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Cigna

Find a Medicare Plan Near You!

Speak to a licensed broker who can help you look for plans.

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