Open Enrollment & Incontinence Care: What to Know About Insurance Coverage for Supplies

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.