Ordering adult urology products when you have Medicare coverage

When you're living with incontinence or need access to urology products, having access to the right supplies may help you resume doing the things you love. Many adult urology supplies are covered by Medicare, so it may be possible to get the products that you need without paying out-of-pocket.

Whether or not urology products are covered by Medicare depends on the type of coverage you have, the type of supplies you need, and the medical-equipment supplier you use. Here's what you need to know about Medicare coverage and adult urology products.

How Medicare covers urology products

A variety of adult urology products are available for purchase, including catheters, urostomy supplies, briefs, and more. Your doctor will determine the products you need based on your personal circumstances. In many cases, your doctor may prescribe the necessary supplies, just like they prescribe medication.

If a doctor determines that urological products are medically necessary for you, supplies like catheters or intermittent catheters, urine collection bags, or urostomy pouches should be covered under Medicare Part B. To fully benefit from Medicare Part B coverage for urology products, you must fill your order through a participating medical-equipment supplier such as Edgepark. Adult diapers aren't covered by Medicare Part B. They also aren't prescribed by doctors because they're available over the counter.

Why choosing a supplier that "accepts assignment" saves you money

Medical-equipment suppliers need to "accept assignment," meaning that they agree to accept Medicare-approved fees for medical supplies. When a supplier accepts assignment, Medicare Part B covers 80% of the cost of these supplies, and you'll be responsible for 20% once you meet your annual deductible. If you have a Medigap plan (additional coverage you can purchase to fill the gaps in your Medicare coverage), some (or all) of the 20% you owe may be covered by your supplemental insurance.

By using a supplier that accepts assignment, you'll likely save money. When you have Medicare, providers that don't accept assignment may charge up to 15% more than the Medicare-approved fees, but Medicare will only cover the supplies at their pre-approved amount. You'll owe 20% of the approved amount, plus any overages that the supplier charges.

Suppliers that honor Medicare-approved fees usually wait for Medicare to pay their portion of the fee before asking you for your portion, rather than asking for payment upfront. Other suppliers may require full payment at the time of service, and claims are submitted to Medicare for partial reimbursement after payment.

How to order urology supplies when you have Medicare

When your doctor prescribes urology products, they may give you the prescription or send it to a supplier electronically. You can place an order for the supplies you need online or by phone.

Edgepark's Customer Care team can help you receive your urology products quickly. They'll find out everything they need to know about your Medicare coverage and any supplemental insurance, and they'll provide information about the products your doctor has prescribed.

In order for Medicare to cover their portion of the supplies, they may need to confirm that the urology products are medically necessary. They may need your medical records or other information from your healthcare provider to confirm your health condition is of "long and indefinite duration," which means the condition will last at least three months.

Edgepark's Customer Care team can help you navigate this process since they frequently assist people in this capacity. They can connect with your healthcare provider to get the necessary information about your health, then provide it to Medicare. The experienced Customer Care team is also poised to answer questions you may have about urology supplies, Medicare coverage, supplemental insurance, or anything else related to your order.

To get adult urology supplies from a supplier that accepts Medicare, can provide education about its products, and streamlines the ordering process, visit Edgepark's website.