Background
The Florida Health Justice Project and Disability Rights Florida brought a class action lawsuit against Florida’s Agency for Health Care Administration (AHCA). AHCA, as the state’s Medicaid agency, was refusing to cover medically necessary incontinence supplies for adults over the age of 21. We were successful and settled the case.
Now, Florida Medicaid covers medically necessary incontinence supplies for people who are over the age of 21. Medicaid will now cover incontinence supplies no matter a Medicaid beneficiaries’ age or whether they are on a Home and Community Based Services (HCBS) waiver or not. If you think you need incontinence supplies, please talk with your doctor.
What are Incontinence Supplies?
Incontinence supplies are things like diapers or underwear. These supplies help people who can’t control their bladder or bowels. A few examples include:
- Disposable incontinence briefs
- Adult diapers
- Protective underwear
- Pull-Ons
- Liners
- Shields
- Guards
- Pads
- Undergarments
A full list of incontinence supplies covered by Medicaid are available in their document. Pages 2 and 3 of the document lists what supplies Medicaid covers.
If You Have Trouble Getting Supplies
- Doctors may be unaware that Medicaid now covers incontinence supplies. The same is true for providers of medical supplies as well as Medicaid managed care plans. If your provider or managed care plan tells you Medicaid does not cover incontinence supplies for adults unless they are on a HCBS Waiver, show them this announcement from Medicaid that tells providers they cover the supplies now.
- If you’re still having trouble educating your providers or Medicaid managed care plan about the change, you can file a grievance with the Agency for Health Care Administration. Here are instructions on filing a grievance which can be used to file complaints against Medicaid plans AND providers: How to File a Medicaid Managed Care Complaint.
Why This is Important
If you have Medicaid and have a medical need for incontinence supplies, you should know about this change to your coverage. Clean, frequently changed, and form-fitting incontinence supplies are essential to keeping people who need them safe. Unchanged and soiled supplies cause health risks, namely skin breakdown and infections. People who need these supplies and qualify for coverage under Medicaid deserve the independence and dignity to feel comfortable and clean.
What to do if you face barriers?
If you face barriers to getting your medically necessary incontinence supplies, contact the Florida Health Justice Project.
Please use all the above resources to advocate for yourself and what you deserve. Visit our self-advocacy resource page for more information about how to support yourself in getting what you need.