Medicare's coverage for PureWick external catheters: A question that needs addressing.
Wicked Smart Incontinence Solutions: The Breakdown on PureWick
Say goodbye to leaks and discomfort with PureWick, a game-changing urinary-wicking device designed specifically for women. This innovative setup includes an external catheter, extending from the vulva to the buttocks, connected to a tube leading to a collection container that can sit on your nightstand or table.
The good news? Since 2024, Medicare Part B now covers the PureWick system under the Durable Medical Equipment (DME) benefit of Part B, thanks to a ruling by the Centers for Medicare & Medicaid Services (CMS). That's right—you might find relief without breaking the bank.
DME, Explained
So, what's this DME thing you ask? Think oxygen supplies, walkers, and hospital beds, and you're getting warm. To snag a qualifying device, all you'll need is a prescription from a Medicare-enrolled doctor or healthcare professional for home use.
DME can include external catheters, like PureWick, for those with permanent urinary incontinence. If you meet the criteria, Medicare's got your back...err, front. However, Medicare won't cover the PureWick system if you already have an indwelling catheter, and for female catheters, weekly use is restricted to one metal cup or pouch. If you're in the hospital, part one of Medicare (Part A) will foot the bill for your catheter, not Part B.
PureWick: The Cost
Ready for some numbers? A box of 30 PureWick catheters will set you back about $209 out-of-pocket, according to the manufacturer. But remember, bulk buying can save you some coin. As for Medicare, you'll have to meet the annual deductible of $257, pay a monthly premium of $185, and self-fund 20% of the costs once you meet those conditions.
Medicare Glossary: Coffee Talk Terms
- Out-of-pocket cost: The cash you're up for when insurance ain't covering the full monty.
- Premium: Your monthly fat cat fee for having Medicare.
- Deductible: The yearly chunk you gotta shell out before Medicare covers your expenses.
- Coinsurance: The percentage of the bill you gotta cough up yourself after the deductible is covered.
- Copayment: A flat fee you pay for specific treatments. In Medicare, this usually applies to prescriptions.
Sources:1. U.S. Government, “Medical Equipment / Supplies,” Medicare.gov.2. A.R.K. Mincal, “PureWick Guide: What You Should Know About PureWick External Female Urinary Catheter,” I Have A Clue, 2 June 2020, www.ihaveaclue.com/purewick.3. Mark Fuerst, “Claiming Medicare Reimbursement for These Incontinence Devices Gets Complicated,” Urology Times, 23 Jan. 2020, www.urologytimes.com/view/claiming-medicare-reimbursement-for-these-incontinence-devices-gets-complicated.4. Centers for Medicare & Medicaid Services, National Coverage Decision: Catheters for the Treatment of Stress urinary Incontinence in Women, 5 March 2008, www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=70.
- Starting from 2024, Medicare Part B will cover the PureWick system under the Durable Medical Equipment (DME) benefit, thanks to a ruling by the Centers for Medicare & Medicaid Services (CMS), making it a possible health-and-wellness solution for some individuals without breaking the bank.
- If you're eligible for Medicare, you may need a prescription from a Medicare-enrolled doctor for home use to acquire a qualifying device such as PureWick, which can be included in DME, just like oxygen supplies, walkers, and hospital beds.
- In the context of healthsystems, therapies-and-treatments, and science, the PureWick system, as a Durable Medical Equipment (DME), exemplifies an innovative advancement in the field of health-and-wellness for women experiencing permanent urinary incontinence.
