Coverage for incontinence supplies

Posted
by Race Mom Race Mom, ASN, RN Member Nurse

Specializes in NICU/L&D, Hospice. Has 8 years experience.

Pt has private insurance. Is hospice required to provide incontinence supplies for a pt on hospice with need for incontinence supplies (chux, etc). No other dx other than what pt is on hospice for. Young pt with no previous need for incontinence supplies.

Thanks!

coffeetalker

coffeetalker

63 Posts

Any supplies needed to provide care for the pt are covered under hospice- hence all the hoopla about wound care supplies and not using a $4.oo dressing if a 75 cent dressing will do the job.

Race Mom, ASN, RN

Specializes in NICU/L&D, Hospice. Has 8 years experience. 807 Posts

I used to be a hospice CM. I asked our hospice RN CM (for our family member on hospice) for a pack of chux pads and she told me they don't supply them but I could go to the store and buy some, same with briefs. I was always under the impression that hospice covered these supplies so I became pretty confused by her answer.

nutella

nutella, MSN, RN

1 Article; 1,509 Posts

Pt has private insurance. Is hospice required to provide incontinence supplies for a pt on hospice with need for incontinence supplies (chux, etc). No other dx other than what pt is on hospice for. Young pt with no previous need for incontinence supplies.

Thanks!

If the payer is Medicare (medicare hospice benefit) it is my experience that hospice pays for those supplies - sometimes they have some packages at the office but often it needs to get order and sent directly to the house.

If the payer is not medicare but insurance benefit my agency still covered those supplies - as I said above - they were send out directly to the house.

4boysmama

4boysmama

Specializes in Hospice + Palliative. Has 4 years experience. 273 Posts

mine covers briefs/pullups, provides 2-3 waterproof pads (not chux), but not disposable wipes. gloves only if they have a wound.

toomuchbaloney

toomuchbaloney

Specializes in NICU, PICU, Transport, L&D, Hospice. Has 43 years experience. 8,954 Posts

I have yet to encounter a hospice benefit which did not include basic caregiving supplies like incontinence briefs, chux, etc. If the company says no, do some digging as there is something unusual and wrong going on...IMHO

Zee_RN

Zee_RN, BSN, RN

Specializes in Hospice, Critical Care. Has 17 years experience. 951 Posts

We cover incontinent supplies including briefs, chux, creams, wipes ... but we do not provide pull-ups as Medicare has classified them now as "underwear." Some hospices do, though. We have opted not to.

ktwlpn

ktwlpn, LPN, RN

Specializes in Med Surg, Homecare, Hospice. 3,844 Posts

[quote name=Race mom) Young pt with no previous need for incontinence supplies.

Thanks![/quote]

Why the need now? If due to functional or cognitive decline it makes sense.If the want to stockpile chux for their puppy it's an issue.Every hospice I work with provides incontinence products for their clients in the LTC

Race Mom, ASN, RN

Specializes in NICU/L&D, Hospice. Has 8 years experience. 807 Posts

No, no puppies :) This was for my sister who went on hospice. She had some incontinence at one point, when they had her overmedicated. I asked for some chux and was denied. They told me they didn't provide them, but were very happy to tell me where I could buy them. Funny twist from what you said about the puppy. They had some of those pads at home and we decided we would just use those if we needed to. Pretty sad.

Swati

Swati

Specializes in Home health & Hospice. Has 12 years experience. 1 Post

If the hospice has Medicare accreditation then Hospice has to provide everything what Medicare covers but only related to the hospice diagnosis. Other items are in non-covered item list so if those are related to non hospice diagnosis,  will be covered by Medicare separately. Medicare doesn't cover any incontinence supplies so Hospice is not obligated to provide those. For more information visit medicare.gov Medicare covered supplies. You also can download the Medicare app for quick search to find out covered items. After all it is up to the Hospice to decide whether they want to spend out of their pocket.