Medicare's coverage for PureWick external catheters: a question addressed
Are You Struggling with Incontinence? PureWick Might Be Your Solution
Say goodbye to frustrating accidents with the innovative PureWick system, designed specifically for women to use during sleep or rest. This nifty device includes an external catheter that extends from the vulva to the buttocks, connected to a tube leading to a collection container, which can be placed on a nightstand or table.
Interested in obtaining coverage for PureWick through Medicare? Here's what you need to know!
The Easy peasy Coverage Way with Medicare
Medicare Part B offers coverage for Durable Medical Equipment (DME), essential medical items such as oxygen supplies, walkers, and hospital beds. As long as a Medicare-enrolled doctor or healthcare professional prescribes a qualifying device for home use, a Medicare-enrolled individual can get it.
As of 2024, external catheters, like the PureWick system, are included under DME coverage for individuals with permanent urinary incontinence. However, it's important to note that Medicare will not approve coverage if you already have an indwelling catheter. Also, the usage of female catheters is limited to no more than one metal cup or pouch per week. In a hospital setting, catheters will be covered by Part A.
Know Your Costs!
Expect to pay around $209 for a box of 30 PureWick catheters if you're paying out-of-pocket without insurance. However, purchasing in bulk can help save some money.
As of 2025, those enrolled in Medicare Part B must meet an annual deductible of $257 and pay a monthly premium of $185. Once these conditions are met, Part B will cover 80% of approved treatments or services.
If you're hospitalized, most people are exempt from paying a premium, but you must meet a deductible of $1,676. Afterward, Part A will cover your hospital stay and any necessary medical devices completely for the first 60 days.
Worried about the details? Don't be! Medicare Advantage (Part C) plans are private plans that offer the same benefits as Original Medicare. Premiums, deductibles, and coinsurance will vary depending on the plan.
Time to Up Your Medicare Vocabulary
- Out-of-pocket cost: A payment made when Medicare does not cover the total cost or the service.
- Premium: The monthly fee for Medicare coverage.
- Deductible: An annual amount you must pay out of pocket before Medicare begins funding treatments.
- Coinsurance: The percentage of treatment costs that you must pay.
- Copayment: A fixed dollar amount you pay during treatments, especially for prescription drugs.
Note: Medicare reimbursement for catheters requires specific documentation and authorization, although the exact start date for Medicare coverage of PureWick external catheters is not specified. To get accurate coverage and cost details, consult Medicare's official guidelines or contact a Medicare representative directly.
[1] Source: Medicare guidelines for reimbursement of catheters
[5] Source: PureWick At Home System price
- If you're considering Medicare coverage for PureWick, it falls under Durable Medical Equipment (DME) under Medicare Part B.
- As of 2024, individuals with permanent urinary incontinence are covered for external catheters like PureWick, but not if you already have an indwelling catheter.
- When purchasing PureWick out-of-pocket without insurance, you can expect to pay around $209 for a box of 30 catheters.
- To fully understand the coverage details for PureWick under Medicare and the associated costs, familiarize yourself with the Medicare terms including out-of-pocket cost, premium, deductible, coinsurance, and copayment.
