Youth Incontinence and Medicaid

July 18, 2018

By Janet Firestone, Medicaid Account Executive

Caring for a child with special healthcare needs can be an overwhelming journey between doctor appointments, therapies, and medical supplies. An article in Complexchild.org titled, Diaper and Incontinence Product Coverage through Medicaid and Insurance, highlights that diapers are one of the largest daily expenses that many families face. In fact, some families will spend over $120 a month on incontinence products. Did you know that in most states Medicaid eligibility starts at age 3 or 4 if the child has a medical necessity or a qualifying diagnosis? While it is great to be awarded for medical necessity, it is important to note that not all incontinence products are equal.

High quality absorbent incontinence products have been proven to reduce caregiver stress by decreasing the number of accidents resulting in laundry, cleaning, and changes. More importantly, highly absorbent products can improve outcomes as well.

Janet Firestone, Medicaid Account Executive for Tranquility Products, knows firsthand the impact high quality products have for the clients she serves. She recently shared a story about a grandmother in New York who was caring for her granddaughter with Cerebral Palsy. They used Tranquility incontinence products for over 15 years with no issues. Due to state changes, the provider was forced to switch her granddaughter to a lower-quality product. There was an immediate impact on her granddaughter because of the switch; an increase in Urinary Tract Infections and later skin breakdown.  The child ended up in the Emergency Room and was admitted to the hospital, later developing Clostridium difficile (C-Diff) – all these issues because of a switch to lower-quality incontinence product. The grandmother reached out to Tranquility Products and was connected to Janet. Janet worked with her and their physician to write a “Letter of Medical Necessity” to try to regain coverage for high-quality products. The granddaughter was awarded medical necessity for Tranquility products and is in the products once again with no health issues.

Today, Janet helps to educate case managers around the country about why high-quality incontinence products from Tranquility perform best for their clients on Medicaid. Each state is different and has different Medicaid incontinence benefits. Incontinence products are covered by Medicaid in most states; however, some states make it more difficult to receive this benefit. For tips on how to write your own letter of necessity, please refer to the article on complextchild.org.

Everyone deserves access to quality products. They are certainly what all social workers (case managers) want for their clients living with special health care needs. High quality products are what set some Durable Medical Equipment Supplier (DMEs) apart from the others, by changing the lives of the individual wearing the products and their caregivers. Quality products such as Select® or ComfortCare® from the maker of Tranquility® are generally available to you under Medicaid.

Call Tranquility Products today to find the Medicaid provider in your state that offers Select or ComfortCare! Call our Customer Care Center at 1-800-467-3224 x 7 M-F 8 a.m. to 5 p.m. ET.

Learn more about Medicaid and Incontinence at Complex Child

Please Note: Tranquility Products in not a Medicaid supplier, but can help you locate a dealer near you.