Author: Andrea Miller
Reviewed By: Kristi Bickmann
Original Medicare (Parts A and B) doesn’t pay for adult diapers in assisted living or any other residential setting. Members must cover 100% of the cost of diapers and other incontinence supplies. However, Medicare Advantage plans may cover some over-the-counter health supplies, including adult diapers. In addition, Part D (prescription drug coverage) may include discounts for medical supplies, such as adult diapers. Review your plan documents carefully, or talk to an agent to find out if you have this type of coverage.
If you qualify for Medicaid, your plan may pay for medically necessary adult diapers. Medicaid is a federal and state program that provides health insurance for people who have a disability or earn limited income. While plans vary by state, most states offer coverage for incontinence supplies, such as adult diapers.
Adult diapers may be medically necessary if you have urinary incontinence, a condition that affects about 25% of Americans. It causes involuntary urine leakage, which can lead to infections, skin ulcers and other health complications. Many health conditions, such as diabetes, stroke, Parkinson’s disease or dementia, can lead to urinary incontinence.
It can also occur if you have weak or overactive bladder muscles, an enlarged prostate or a vaginal or urinary tract infection. Some medications cause urinary incontinence as well.
