Medicare coverage for PureWick external catheters: Clarification required?
Managing Incontinence with PureWick: A Comprehensive Guide
Say goodbye to leaky moments with urinary-wicking devices like PureWick, a revolutionary solution designed for ladies during sleep or rest.
The PureWick system comprises an external catheter, extending from the vulva to the buttocks, connected to a tube leading to a collection container. These containers can be positioned on a nightstand or table for ease.
As of a 2024 ruling by the Centers for Medicare & Medicaid Services (CMS), Medicare now covers the PureWick system under its durable medical equipment (DME) benefit of Part B.
Sex and gender exist on spectrums. This article will use the terms "male," "female," or both to refer to sex assigned at birth. Learn more.
eligibility for Medicare PureWick Coverage
Medicare Part B covers DME, which encompasses vital medical items such as oxygen supplies, walkers, and hospital beds. If a Medicare-enrolled person receives a qualifying device with a prescription from a Medicare-enrolled doctor or healthcare professional, it's eligible for home use.
DME can include external catheters as alternatives to indwelling catheters for individuals with permanent urinary incontinence. As of 2024, Medicare includes the PureWick system in this coverage. However, Medicare won't cover it if an individual already has an indwelling catheter, and for female catheters, Medicare limits usage to one metal cup or pouch per week. In a hospital setting, catheters will be covered by Part A.
Costs associated with Medicare PureWick coverage
As stated on the manufacturer's website, a box of 30 catheters costs approximately $209 for those paying out of pocket without insurance. Reducing costs through bulk purchases is possible.
As of 2025, those enrolled in Medicare Part B must meet the annual deductible of $257 and pay a monthly premium of $185. Once enrollees meet these conditions, Part B will cover 80% of approved treatments or services.
With Part A, most people are exempt from paying a premium, but they must meet a deductible of $1,676. Afterward, Part A will cover their hospital stay and any necessary medical devices during that period fully for the first 60 days.
Medicare Advantage (Part C) plans are private plans that must provide the same benefits as Original Medicare. The premiums, deductibles, and coinsurance vary depending on the plan.
Medicare Glossary
- Out-of-pocket cost: The amount a person must pay for care when Medicare does not pay the total amount or offer coverage. This could involve deductibles, coinsurance, copayments, or 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 to fund their treatments.
- Coinsurance: The percentage of treatment costs that a person must self-fund. For Medicare Part B, this is typically 20%.
- Copayment: A fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
- Incontinence management with PureWick involves the use of a revolutionary external catheter system, covering ladies during sleep or rest.
- As per a 2024 ruling by the Centers for Medicare & Medicaid Services (CMS), PureWick system falls under Medicare's durable medical equipment (DME) benefit of Part B.
- Medicare-enrolled individuals qualifying for a device with a prescription from a Medicare-enrolled doctor or healthcare professional can avail the home use of these devices, including PureWick.
- For female catheters like PureWick, Medicare limits usage to one metal cup or pouch per week, and it won't cover PureWick if an individual already has an indwelling catheter.
- The cost for a box of 30 PureWick catheters can amount to approximately $209 for people paying without insurance, but saved costs can be achieved through bulk purchases.
- Both Original Medicare and Medicare Advantage plans must provide coverage for essential health-and-wellness therapies and treatments, women's health, science, and medicare devices, along with out-of-pocket costs, premiums, deductibles, and coinsurance specifics that may vary depending on the Part C plan.
