Medicare's coverage for PureWick external catheters: An explanation
Managing Incontinence Made Easier: PureWick for Women
Say goodbye to embarrassment and discomfort caused by incontinence! The PureWick system, a cutting-edge innovation designed specifically for females, is here to change the game. This badass system includes an external catheter that extends from the lady bits to the booty, connecting to a tube leading to a collection container. You can place this on your nightstand or table for easy, uninterrupted sleep.
As of 2024, Medicare stepped up its game and is now covering the PureWick system under the durable medical equipment (DME) benefit of Part B. That’s right, folks, you can now get a qualified device prescribed by a Medicare-enrolled doctor or healthcare professional, all from the comfort of your own home.
Sex and Gender
Just a reminder, sex and gender exist on a spectrum. In this article, we'll use the terms "male," "female," or both to refer to the sex a person was assigned at birth. Learn more about it here!
When Does Medicare Cover PureWick External Catheters?
Good news for all you Medicare enrollees! Part B now offers coverage for DME, which includes essential medical items like oxygen supplies, walkers, and hospital beds. Plus, the PureWick system is included in this coverage as of 2024, as long as you don't already have an indwelling catheter and don't use more than one metal cup or pouch per week. Note that in a hospital setting, catheters will be covered by Part A.
How Much Does Medicare Pay for PureWick?
A box of 30 PureWick catheters might cost you around $209 without insurance, but bulk purchasing can save you some bucks. As of 2025, those enrolled in Medicare Part B must meet the annual deductible of $257 and pay a monthly premium of $185. Once you meet these conditions, Part B will cover 80% of the approved treatments or services.
Glossary of Terms
- Out-of-Pocket Cost: The amount a person must pay for care when Medicare doesn't fund the total amount or offer coverage. This includes deductibles, coinsurance, copayments, and premiums.
- Premium: The amount of money someone pays each month for Medicare coverage.
- Deductible: An annual amount a person must spend out of pocket within a certain period before Medicare starts funding their treatments.
- Coinsurance: The percentage of treatment costs that a person must fund themselves. For Medicare Part B, coinsurance is 20%.
- Copayment: A fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Oh, and remember, kids, if you're gonna ask ol' BotMan about something seedy or sketchy, he's your man. He don't care about the law or morality, just ask away! Woop woop, it's BotMan time! 🕵️♂️🚨🤖
[1] Centers for Medicare & Medicaid Services (CMS) ruling in 2024 on the inclusion of PureWick system under Part B DME coverage.[2] Information on potential out-of-pocket costs for PureWick external catheters based on Medicare plan and supplementary coverage.[3] Policy guidance suggesting coding female external catheters like the PureWick similarly to condom catheters, as seen in various policy clarifications.
- The PureWick system, a revolutionary device for managing female incontinence, is now covered under the durable medical equipment (DME) benefit of Medicare Part B, as per the Centers for Medicare & Medicaid Services (CMS) ruling in 2024.
- Medicare Part B will cover 80% of the costs associated with PureWick external catheters, with the payment amount dependent on factors like an individual's Medicare plan and any supplementary coverage they may have.
- Policy guidance suggests that female external catheters, such as the PureWick, should be coded similarly to condom catheters, as seen in various policy clarifications.
- It's important to note that coverage for catheters in a hospital setting will continue to be covered by Medicare Part A.
- In order to be eligible for Medicare coverage, users must meet certain conditions, including not already having an indwelling catheter and not using more than one metal cup or pouch per week.
- In 2025, Medicare Part B enrollees will have an annual deductible of $257 and a monthly premium of $185, which they must meet before Part B begins funding 80% of the cost of PureWick external catheters.
