Help with purchasing catheters

[PKS]

Everyone- thank you so much for the insightful information. After realizing how bad my insurance is, I've decided the easiest and only way to do this is paying out of pocket because the appeal I've written will probably not help much anyway.
thank you all!

[ronniesmom]

Hello. I have been a long-time lurker on this site. My child requires cathing every 4 hours due to her neurogenic bladder. We have had UHC for years, and for years we have been having to pay put of pocket for her supplies. Related to the advice I read on this site, I decided to make my yearly call to UHC and attempt to see if her catheters would be covered. I actually got a "yes"!! I called 1-80-Medical (877) 688-2729 and spoke with Brett, he knew exactly what codes and how to get UHC to pay for them. We even got the touchless kind. Thought I'd let you know, so if you have given up on your insurance paying for your supplies, it might warrant a call to check, something may have changed, or maybe Bret can help you get codes that they WILL pay for. Thank you again.

[gjnl]

I am wondering if your catheters are being prescribed and coded correctly. Every health insurance coverage I have had considered intermittent and foley catheters Durable Medical Equipment (DME)-not disposable medical equipment-under this definition:
A urinary collection and retention system with or
without a tube is a prosthetic device replacing
bladder function in case of permanent urinary
incontinence. The foley catheter is also considered a
prosthetic device when ordered for a patient with
permanent urinary incontinence.

Lubricants and antiseptic wipes have not been covered because they are classified as disposable items. I always thought it odd that insurance would cover the catheters, but not cover the items to make them easier and safer to use.

All the best,
GJ

[wheeliecoach]

Originally Posted by PKS

I have United Healthcare Virginia insurance that will not pay for catheters (United Healthcare doesn't pay for disposable medical supplies.... strange isn't it?), I'm wondering if anyone was in a similar situation and could tell me what did you do to solve this problem. Also, is there anyone who pays for hydrophilic catheters out of pocket? If so, please give me information where I can buy it for a reasonable price....this is urgent.

When we had United Healthcare they paid for catheters...along with other things. I think you should challenge that...