Medicaid Coverage
CWI Medical does not bill insurance, however 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).
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.
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.
To see if you or a loved one qualifies for Medicaid click here - Medicaid.gov .
Please click here for more information – http://kff.org/health-reform/ .
Flexible Spending Accounts (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.
For a list and additional information about FSA Eligible items, click here
Helpful Organizations
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.
Medicare & Private Insurance
CWI Medical does not bill Medicare or other insurance companies directly; however, by the following these steps you may be able to receive up to 80% reimbursement on certain products (see qualifications below). Please note that these guidelines apply generally but do not constitute a guarantee of reimbursement approval. For exact eligibility information please contact Medicare or your insurance provider directly.
In cases of eligibility, to secure reimbursement you will need to submit a doctor’s prescription for the item ordered; proof of delivery, such as a packing slip or shipping receipt; and, in some cases (for Medicare reimbursements), Form 1490.
Eligible products for reimbursement
Medicare eligibility requirements vary from product to product. Therefore, please read the guidelines below to determine whether your specific product qualifies for Medicare reimbursement. For other insurance providers, please contact the company directly to ascertain their policy for each item.
Power Wheelchairs and Mobility Scooters
To qualify for a power wheelchairs and mobility scooters reimbursement, a patient must meet the following criteria:
Lift Chairs
To qualify for a lift chair reimbursement, a patient must meet the following criteria:
Note that, even in qualifying cases, Medicare covers only the seat-lift mechanism itself (typically up to $300, depending on the state). In addition, the patient’s attending physician for the condition under treatment must also be the prescribing physician for the chair lift.
Bathroom Safety Aids
Unfortunately, Medicare will not reimburse for most bathroom safety aids. However, patients that are unable to access their bathroom may qualify for bedside commode as well as patients with a qualifying diagnosis may be eligible for a rehab shower commode chair.
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