Open enrollment season is here! If you or someone you care for lives with incontinence, this is an ideal time to review your health coverage and make sure your plan includes the supplies you depend on.
Insurance can be confusing, especially when it comes to what’s covered and what’s not. That’s where ActivStyle comes in.
At ActivStyle, we make this process easy. Our compassionate Product Experts help patients verify coverage, handle the complicated paperwork with insurance and your physician, help you find the right products for your needs, and arrange discreet home delivery of high-quality incontinence supplies. We’re here to take the confusion out of coverage and make your life easier.
Here’s what you should know this open enrollment season.
1. Which Insurance Plans Cover Incontinence Supplies and Which Don’t
One of the most common questions we hear is: “Does my insurance cover incontinence supplies?”
The answer depends on the type of plan you have. Here’s a quick breakdown:
| Insurance Type | Covers Incontinence Supplies? | Notes |
|---|---|---|
| Medicaid / Medicaid Managed Care (MCO) | Yes | Coverage varies by state and plan; prescription required |
| Private / Managed Care Plans | Sometimes | Depends on DME (Durable Medical Equipment) benefits |
| Medicare / Medicare Advantage | No | Covers some urology or ostomy supplies only |
Medicaid and Medicaid MCO Plans
Medicaid and Medicaid MCO plans are the most common types of insurance that cover incontinence supplies. These plans often provide medically necessary items such as adult briefs, pull-ons, bladder control pads, and underpads, but the exact products and quantities differ by state and by plan.
Private and Managed Care Insurance Plans
Some private or managed care insurance plans may also include incontinence supplies under their Durable Medical Equipment (DME) or Medical Supplies benefit. However, coverage isn’t guaranteed. That’s why it’s important to check your plan and confirm your eligibility with ActivStyle before making any changes during open enrollment.
Medicare and Medicare Advantage
Medicare and Medicare Advantage plans do not cover incontinence supplies. While Medicare may cover a limited number of urology or ostomy products, these are specialized items and not the same as incontinence supplies.
Quick Tip: Check the front of your insurance card. If it lists a Medicaid or Managed Care Organization, you may qualify for covered supplies through ActivStyle.
2. Why Coverage Varies by State and Plan
When it comes to insurance, there’s no one-size-fits-all answer. Medicaid and managed care programs are administered by individual states, meaning:
- Coverage rules differ from state to state.
- Plans may have different product limits or documentation requirements.
- Not every plan is contracted with ActivStyle.
ActivStyle is a licensed Medicaid provider in 43 states and the District of Columbia, but we’re not in-network with every plan in every state. Some plans contract exclusively with one provider, and if you are not careful you can lose our ability to choose your incontinence provider. That’s why reviewing your plan during open enrollment is so important, especially if you’re considering switching coverage.
Changing to a plan that’s out-of-network could delay or interrupt your supply shipments. Our Product Experts can help you confirm whether your plan is in-network and ensure a seamless experience.
3. Understanding Medicaid Managed Care (MCO) and Private Plans
If you’re enrolled in a Medicaid Managed Care Organization (MCO) or a private health plan, coverage for incontinence supplies may still be available, but it depends on your specific benefits.
- MCO plans are Medicaid-administered health plans managed by private insurance companies. They typically require members to use in-network providers for covered services.
- Private or employer-based plans may cover incontinence products under their Durable Medical Equipment (DME) or Medical Supplies benefit, but they rarely do.
Quick Tip: If your Medicaid plan includes terms like “QMB” (Qualified Medicare Beneficiary) or “SLMB” (Specified Low-Income Medicare Beneficiary), these types do not cover incontinence supplies.
If you’re unsure what type of plan you have or what it covers, don’t worry, ActivStyle’s friendly Product Experts can help you find out in just a few minutes.
4. How to Check If Your Plan Is In-Network
Checking your plan is easy with ActivStyle. Here’s how:
Step 1: Gather your insurance information
Have your insurance card nearby. You’ll need your plan name and ID number.
Step 2: Contact ActivStyle
Call our dedicated intake line at 1-888-273-4535 or complete our secure online form. A Product Expert will collect your information and verify your eligibility.
Step 3: We’ll handle the rest
If your plan is in-network, we’ll contact your doctor for the prescription and submit everything to your insurance provider.
Step 4: Receive your supplies
Once approved, your incontinence products are delivered discreetly to your home each month. No store visits, no hassles.
At ActivStyle, our mission is simple: We’re committed to making your life easier.
5. What to Do During Open Enrollment
Open enrollment is the time to review your plan, confirm your coverage, and make any necessary changes before the new year begins.
Here’s a quick checklist for open enrollment success:
- Review your current plan benefits and coverage.
- Confirm whether your plan (Medicaid, MCO, or private) covers incontinence supplies.
- Check if ActivStyle is in-network for your plan.
- Contact ActivStyle to verify your eligibility before changing plans.
- Sit back and relax while we handle the paperwork for you.
Making these checks now ensures that you’ll continue receiving your supplies without interruption or surprise costs.
6. Why Choose ActivStyle?
For more than 25 years, ActivStyle has helped patients across the country live more confidently through personalized, compassionate care.
With us, you can count on:
- Caring Product Experts who guide you through the process step by step.
- Insurance expertise to verify your plan and handle all paperwork.
- Dependable, discreet home delivery of high-quality, medically necessary supplies.
- Coverage checks across Medicaid, MCO, and private insurance plans.
Our team does more than deliver supplies; we provide peace of mind.
7. Ready to Check Your Coverage? Let’s Get Started
Whether you’re on Medicaid, a managed care plan, or private insurance, ActivStyle can help you find out if your plan covers incontinence supplies.
Check your coverage today. Contact an ActivStyle Product Expert through our intake form or call 1-888-273-4535. We’ll verify your plan and take care of the rest.
We’re Here to Help
Navigating insurance can feel overwhelming, but you don’t have to do it alone. Whether you’re new to ActivStyle or have been with us for years, our caring team is here to make the process simple, so you can focus on what matters most: living confidently, comfortably, and without worry.
Insurance Coverage Questions During Open Enrollment
Does insurance usually cover incontinence supplies?
Medicaid and many Medicaid Managed Care (MCO) plans often include coverage. Medicare and Medicare Advantage plans do not cover standard incontinence products.
Which insurance plans are most likely to cover adult briefs and related supplies?
Medicaid and Medicaid Managed Care plans are the most common sources of coverage for incontinence supplies. Coverage details, such as product types and monthly limits, vary by state and by plan.
Why does coverage for incontinence supplies vary by state?
Medicaid programs are administered at the state level, which means each state sets its own coverage rules. Plans can differ in what products are approved, how many supplies are allowed, and what documentation is required. Provider networks can also vary from state to state.
Is there a difference between Medicaid and Medicaid Managed Care when it comes to supplies?
Yes. Traditional Medicaid is run directly by the state, while Medicaid Managed Care plans are administered by private insurers contracted by the state. Managed care plans typically require members to use in‑network providers, which can affect where you receive your supplies.
Does Medicare cover incontinence supplies during open enrollment?
No. Medicare and Medicare Advantage do not cover standard incontinence supplies like adult briefs or pads. They may cover limited urology or ostomy items, but these are different from everyday incontinence products.
Should I verify my incontinence coverage before changing plans during open enrollment?
Yes. Changing to a plan that doesn’t cover incontinence supplies or isn’t in‑network with your provider can delay or interrupt deliveries. Confirming coverage before switching plans helps prevent gaps in care and unexpected out‑of‑pocket costs.
How do I check if my insurance plan is in network for incontinence supplies?
You’ll need your insurance card with your plan name and ID number. A coverage check can confirm whether your plan includes incontinence supplies and whether your provider is in network. This step is especially important during open enrollment when plan options are changing.
