FAQ & Organizations
Depending on your location and insurance, you may be eligible for reimbursement. Contact your healthcare provider or Medicaid for more information on how to obtain your reimbursement. Eligibility for incontinence supplies may be available if you are already signed up with Medicaid (including a Medicaid-Waiver or Medicaid Health Plan for adults).
Most states cover the following disposable protective products and supplies on a monthly basis:
- Adult briefs
- Protective underwear (Also referred to as Pull-ups)
- Bladder control pads and Pantiliners for women, or absorbent guards for men
Some states also cover:
Each state operates a Medicaid program that provides health coverage for the elderly, people with disabilities, and lower-income people, families, and children. The eligibility rules for Medicaid are different for each state, but most states offer coverage for adults at a certain income level who have children.
There are many types of people or families who may be eligible to receive Medicaid. Some of these categories of eligibility are low-income families with children, low-income people with disabilities, and foster children. Medicaid services offered in your state for people who are “categorically eligible” may vary.
Coverage varies by state and is subject to change.
We recommend that you work with a Medicaid-registered Home Medical Supplier that can make recommendations on the products covered in your state, ship products to your home, and handle the billing for you. If you qualify, ask for the Prevail® brand. You have a choice in asking for the brand and quality of products that you think suit you best. For a list of Home Medical Suppliers that may be able to help you find out if you are covered for absorbent incontinence supplies.
Find out where to buy on the Prevail® products page.
Healthcare reform is in the process of expanding.
To see if you or a loved one qualifies for Medicaid click here - Medicaid.gov.
The Affordable Care Act is impacting Medicaid coverage.
Please click here for more information – http://kff.org/health-reform/.
Flexible Spending Account (FSA)
You can also use a flexible spending account (FSA) to purchase incontinence supplies, but always contact your healthcare provider and/or insurer to confirm which products are covered before buying. Check with your employer for more details and to learn more about your participation in FSA accounts.
If your private insurance plan does not pay for incontinence supplies, you may be able to use flexible spending account funds to cover the costs. Disposable incontinence products that are used to relieve the effects of a diagnosed medical condition are generally covered by medical FSAs. Check with your employer or FSA administrator for more details on which medical expenses are covered by your FSA.
Flexible spending accounts (FSAs) allow employees to contribute pre-tax dollars to an account set up by their employer. The employee determines how much they will spend on uninsured healthcare for the upcoming year and designates an amount to be withheld from each paycheck to fund the account. Contributions made to a flexible spending account are deducted from your pay before your federal, state, or social security taxes are calculated, so that income is not reported to the IRS. Therefore, you decrease your taxable income and increase your spendable income. Employees can withdraw funds tax-free throughout the year to pay for qualified out-of-pocket medical costs.
Across the U.S., there are organizations dedicated to helping you healthfully handle an LOBC experience. From product recommendations to treatments and beyond, these organizations will empower you with information and support.
- American Congress of Obstetricians and Gynecologists (ACOG)
- American Health Care Association (AHCA)/ National Center for Assisted Living (NCAL)
- American Urological Association (AUA)
- Centers for Disease Control and Prevention (CDC)
- Cleveland Clinic
- Family Caregiver Alliance (FCA)
- Health Industry Distributor Association (HIDA)
- International Continence Society (ICS)
- Kaiser Family Foundation
- Medicaid Health Plans of America (MHPA)
- Minnesota Department of Human Services (DHS)
- National Association for Continence (NAFC)
- National Diabetes Education Program (NDEP)
- Simon Foundation
You can get in touch with Healthcare Providers who can help you check into your eligibility for incontinence products. They can guide you through qualification for government sponsored programs and getting/renewing a medical prescription. They will deliver recurring orders discretely to your doorsteps. If you qualify for government-sponsored programs, they will manage billing directly to these programs. This list includes some of the home medical suppliers that can help you through the process of purchasing LOBC supplies.