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What Does Medicare Cover For Catheters?

With Medicare’s ever-changing guidelines for coverage and reimbursement, it can be difficult to keep up with what will actually be covered for your specific medical needs. This is particularly evident in urinary incontinence products, given the wide variety of catheters available. Aeroflow Healthcare aims to be not only your supplier for all your catheter and incontinence needs, but also your source of reliable and relatable information for you to make an informed decision.

Broadly, Medicare covers 200 intermittent single use catheters each month. Beyond the normal straight tip, these can also include Coude tip catheters, depending on the patient’s individual needs and preferences. For the Coude tip type of catheter, a medical need or barrier to using a straight tip catheter must be demonstrated in order for Medicare to cover the Coude tip. This allotment allows patients to change their catheter at least 6 times a day, while still allowing extra catheters should any difficulties with insertion arise.

One of the greatest barriers to regular catheter use is discomfort of insertion. For this reason, Aeroflow recommends a hydrophilic catheter be used for comfort. Hydrophilic catheters are lubricated with sterile saline instead of sterile water, which provides a greater degree of lubrication, decreasing the possibility of failed insertions. By eliminating barriers to reliable and regular catheterization, patients will experience an increase in the effectiveness of their treatment, and increase their quality of life.

Aside from standard intermittent catheters, Medicare will also cover 1 indwelling catheter, or Foley catheter, each month. As with straight tip intermittent catheters, a Coude tip version of the indwelling or Foley catheter is also available, provided patients can demonstrate a medical necessity for this variation. For men, external catheters are also available, with a quota of 35 external catheters per month being covered by Medicare.

One of the most common questions relating to catheterization is the ability to utilize a closed catheter system. Medicare provides for such a setup only if very strict criteria are met to demonstrate medical necessity. Most commonly, a patient will have had “recurrent urinary tract infections while on a program of sterile intermittent catheterization, twice within the 12 months prior to the initiation of sterile intermittent catheter kits.” Additionally, closed catheter systems can be provided to both patients in nursing facilities and patients who are immunosuppressed. Finally, patients with vesico-ureteral reflux while on a program of intermittent catheterization or spinal cord injured females with neurogenic bladder who are pregnant would also be able to utilize such a system under Medicare’s guidelines.

Finally, Medicare provides for more than just strictly catheter needs when it comes to incontinence products. Medicare will also cover a variety of irrigation kits, bedside drain bags, leg bags, irrigation syringes, and extension tubing. For indwelling and Foley catheters, Medicare will also provide various administration and sanitation products such as cath strips, leg straps, tape, and anchor devices. As can be seen, incontinence products are a varied and complex branch of medical products. When choosing what is right for your personal medical needs, trust Aeroflow Healthcare to be with you every step of the way; so qualify for your catheter supplies to be covered by insurance today.

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    I just received my new catheters and couldn't be happier! Aeroflow's customer service representative really went above and beyond to make sure the process was quick and easy.
    "My husband gets his medical supplies from Aeroflow. If we didn't like or trust them, we wouldn't put his health in their hands."
    "I appreciate them calling me each month to ensure I don't forget to order supplies. I don't always remember, but they do!"
    "Aeroflow had a great selection and they were very kind and helpful on the phone. Great people to do business with!"

    "Aeroflow was very professional and helpful! The customer service was great. After making my order it arrived in only two days. Couldn't be more pleased!"