Does Anthem Blue Cross and Blue Shield Cover Incontinence Supplies?
At a glance
- $0 premium plans available in some areas
- Many plans offer prescription drug coverage and vision and dental benefits
- Roughly 3 million people are enrolled in an Anthem Medicare Advantage Plan1
Incontinence supplies are not covered by Original Medicare (Medicare Part and Medicare Part B) but may be covered by a Medicare Advantage plan from Anthem Blue Cross and Blue Shield (Anthem).
Medicare Advantage, or Medicare Part C, provides coverage for all benefits found in Original Medicare as well as additional coverage for things like prescription drugs, dental, vision, or hearing care.
While Medicare Advantage plans do not usually cover incontinence supplies, they may be covered if your plan has an over-the-counter (OTC) benefit.
Keep reading below for more information on OTC benefits, incontinence supplies and Anthem Medicare Advantage plans.
How Do Over-the-Counter Benefits Work?
Coverage of adult diapers and incontinence liners may be offered as an additional benefit in some Anthem Medicare Advantage plans. However, most incontinence products are covered under a plan’s over-the-counter benefits.
OTC benefits typically work by providing a monthly, quarterly or annual allowance on a prepaid debit card. OTC benefits are popular for purchasing non-prescription medications, but in many cases, the card may also be used to purchase other approved OTC products from your local pharmacy or through a catalog offering home delivery.
The list of over-the-counter products covered by Medicare Advantage plans may vary from one plan to another but may include things like cold and cough medications, bandages, vitamins and other items you might find in the pharmacy aisle at your local grocery store.
Are Incontinence Supplies Considered Medical Supplies?
Medicare Part B and Anthem Medicare Advantage plans provide coverage for durable medical equipment (DME), which includes things like wheelchairs, crutches or walkers. However, incontinence supplies do not meet Medicare’s requirements to be classified as DME and are therefore not covered in this manner.
Which Incontinence Supplies May be Covered by Anthem Blue Cross and Blue Shield?
Some of the incontinence supplies that may be covered by a Medicare Advantage plan include:
- Adult diapers: Cloth or disposable diapers worn under the clothes.
Bladder control pads: Flat pads that absorb fluid leakage in females. - Adult briefs: Also known as pull-ons, adult briefs offer better leak protection than bladder control pads and can be used by both males and females.
- Male guards for incontinence: The male counterpart to bladder control pads that keep urine off the skin.
- Booster pads for incontinence: These provide a boost to regular underwear or adult diapers by increasing the surface area in contact with the skin.
- Underpads. Used for cleanup after accidents to protect surfaces from stains.
How Do You Qualify for Incontinence Products?
To qualify for incontinence product coverage, you must be a member of a Medicare Advantage plan that includes OTC benefits, and the list of approved items must include incontinence supplies. Another way to qualify is being enrolled in a plan that offers direct coverage of adult diapers or liners.
You may need to purchase your incontinence supplies from a participating retailer in order to use your OTC benefits or coverage.
How Do You Find an Anthem Blue Cross and Blue Shield Medicare Advantage Plan?
A licensed insurance agent will be able to help you find Anthem Medicare Advantage plans available in your area that provide over-the-counter benefits or other coverage for incontinence supplies.
A licensed insurance agent can also help confirm your Medicare Advantage eligibility and get you enrolled over the phone if you’re eligible.
