Did You Know That Medicaid Provides
Free Diapers and Pull-Ups
for Children With Special Needs?
For many parents of children with special needs, an often sad realization comes when their child is unable or slow to potty train. Some kids, might have difficulty holding their urine, while others are not recognizing the signs of a full bladder. This can sometimes mean a lifelong struggle with managing bladder leakage requiring use of diapers, pull-ups, or catheters. The financial burden that can come with a never ending need to purchase such items along with wipes, disposable bed pads, and bed protectors can be a financial challenge. The good news is that most state Medicaid plans provide full coverage of these supplies for children with special needs over the age of three.
Criteria for Receiving Diapers and Pull-Ups
In order for Medicaid to provide coverage of diapers and pull-ups for your child, they must be experiencing bladder or bowel incontinence on a regular basis. Your child must also have a secondary diagnosis that contributes to their incontinence. Often this is in the form of a specific condition such as Down syndrome, spina bifida, autism, developmental delay, neurogenic bladder, and other conditions or disabilities.
The second piece of criteria required by Medicaid is that your child must be over the age of three while experiencing bladder or bowel leakage. Some states may require that your child is over the age of 4 or 5, but that is less common.
Do All Medicaid Plans Provide Coverage of Incontinence Supplies?
Unfortunately not all Medicaid plans list continence care supplies as a benefit, however the majority do provide coverage of these necessary supplies.
When looking at supplies such as disposable diapers and pull-ups, most state Medicaid plans will fully cover a specific number of these products each month. Some Medicaid plans will also provide coverage of supplemental supplies such as gloves, wipes, and chux pads for additional protection against leaks. The following is a quick criteria coverage list:
• A signed medical necessity letter or prescription from the child’s doctor or healthcare provider within the last 12 months.
• An accurate record of diagnostic information pertaining to the underlying condition as well as any other medical diagnoses.
• An underlying medical condition or diagnosis that causes incontinence.
• The number of times per day the child’s doctor or healthcare provider has ordered the incontinence supplies to be used.
• The number of disposable incontinence supplies requested per month.
• The maximum authorization to receive up to three months of products at a time with updated clinical notes.
Gathering all of the above information and dealing with Medicaid can sound overwhelming. The good news is that durable medical equipment providers (DME’s) such as Aeroflow Urology, are specially trained to work with insurance providers to maximize insurance benefits. Simply complete our form below and let us take care of the rest.
What Products Could My Child Receive Through Insurance?
The supplies your child is eligible to receive will depend on their specific Medicaid plan benefits. If you are unsure which products will best suit your child’s needs, Continence Care Specialists such as those working for Aeroflow Urology, can talk you through various product types and features and can also provide you with samples of different products and brands. They’ll also advise how many products you can receive each month, all at no cost to you.
Diapers – Diapers, also called briefs as your child ages into youth and adult products, are typically the most familiar term for parents who are looking for products for their child. Diapers provide maximum absorbency and feature sturdy, refastenable tabs that make changing easy.
Pull-Ups – Pull-ups, or pull-ons, are another form of absorbent, disposable incontinence product that can easily be pulled on and off. Pull-ups feature an elastic waistband and leg openings for a secure, leak-free fit and are ideal for older, mobile children who prefer a product that closely resembles typical underwear.
Supplemental Supplies – Additional continence care supplies such as disposable or reusable chux pads, sometimes referred to as furniture protectors, as well as disposable gloves and wipes are often available at little or no cost through insurance and can be incredibly beneficial when helping your child with frequent changes.
How Do I Know If My Child is Covered for Free Diapers or Pull-Ups?
Aeroflow Urology, a provider of continence care supplies through insurance, can help you determine your child’s coverage for incontinence products. They take the hassle out of working with your child’s insurance provider and will handle all of the communication and paperwork on your behalf. They’ll even work with your child’s pediatrician to confirm their specific needs and get the appropriate documentation to ensure your child’s supplies are fully covered. Just fill out their quick, two step form and they’ll take care of the rest (just make sure to have your insurance card ready when completing the form). If you prefer to talk with someone over the phone, you can call Aeroflow Urology at 844-276-5588 and speak with a specially trained Continence Care Specialist.
Once your information is received, you will be assigned a dedicated Continence Care Specialist who will begin working to verify your child’s coverage for supplies. They will contact you via phone or email to review the benefits available under your child’s insurance and will then work with you to determine the brand and product type that will work best for your child’s specific needs. Once confirmed, your child’s products will be shipped straight to your door. They’ll also contact you each month to advise when your next shipment will be on the way. #
For more information, visit them online at aeroflowurology.com.