Medicare's coverage for PureWick external catheters: Examination questioned?
Managing Incontinence with the PureWick System
Say goodbye to bulky incontinence products! The PureWick system, a game-changer for women, is here to help you navigate night-time incontinence with confidence and comfort. This ingenious system consists of an external catheter that extends from the vulva to the buttocks, connected to a tube leading to a collection container, which you can position conveniently on a nightstand or table.
Your dreams of coverage for this life-improving device just got sweeter! The Centers for Medicare & Medicaid Services (CMS) made it official with a 2024 ruling that classifies the PureWick system as durable medical equipment (DME) under Part B.
But wait! Before you get too excited, let's brush up on the basics.
What does Medicare Part B cover?
Medicare Part B takes care of essential medical items, such as oxygen supplies and walkers, that are necessary for your home use. To get a qualifying device, a Medicare-enrolled doctor or healthcare professional must prescribe it. Since 2024, external catheters like the PureWick system have become part of the coverage for individuals with permanent urinary incontinence.
However, there's a catch! Medicare won't cover the PureWick system if you also have an indwelling catheter. Furthermore, Medicare strictly limits the use of female catheters to a maximum of one metal cup or pouch per week. In a hospital setting, catheters will be covered by Part A.
Cost, gloriously broken down
As you might find on the manufacturer's website, a box of 30 catheters may cost approximately $209 out-of-pocket without insurance. However, buying them in bulk can save you some dough.
In 2025, those enrolled in Medicare Part B will need to meet an 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. With a deductible of $1,676 for Part A, most people are exempt from paying a premium, but they must cough up these amounts before their hospital stay and necessary medical devices are covered fully for the first 60 days. Medicare Advantage (Part C) plans vary in premiums, deductibles, and coinsurance.
Medicare terms demystified
- Out-of-Pocket Cost: the amount you pay for care when Medicare doesn't fully cover it or doesn't offer coverage.
- Premium: the monthly amount you pay for Medicare coverage.
- Deductible: the amount you must pay annually before Medicare starts funding your treatments.
- Coinsurance: the percentage of treatment costs you must pay yourself.
- Copayment: a fixed amount you pay for certain treatments when using insurance.
Note about sex and gender
Sex and gender are part of an elaborate spectrum. In this article, we will use "male," "female," or both to refer to the sex assigned at birth. Learn more about it here.
[1] Medicare.gov. (2025). Durable Medical Equipment (DME). Retrieved April 1, 2025, from https://www.medicare.gov/coverage/durable-medical-equipment
[2] Durable Medical Equipment, Medicare Administrative Contractors (DME MACs). (2025). About DME MACs. Retrieved April 1, 2025, from https://www.dme-mac.com/about
[3] Medicare Interactive. (2025). Medicare Deductibles and Coinsurance. Retrieved April 1, 2025, from https://www.medicareinteractive.org/get-answers/medicare-costs/costs-in-original-medicare/medicare-deductibles-and-coinsurance
[4] MedicareInfo.gov. (2025). Costs for Medical Services. Retrieved April 1, 2025, from https://www.medicareinteractive.org/get-answers/medicare-costs/costs-in-original-medicare/costs-for-medical-services
[5] Medicare Interactive. (2025). Part A Deductible & Coinsurance. Retrieved April 1, 2025, from https://www.medicareinteractive.org/get-answers/medicare-costs/costs-in-original-medicare/part-a-deductible-coinsurance
- The PureWick system, a life-improving device for managing incontinence, has been recognized by the Centers for Medicare & Medicaid Services (CMS) as durable medical equipment (DME) under Part B, effective from 2024.
- Medicare Part B covers essential medical items, including the PureWick system for individuals with permanent urinary incontinence, as of 2024.
- However, Medicare will not cover the PureWick system if an indwelling catheter is already in use, and it limits the use of female catheters to a maximum of one metal cup or pouch per week.
- The cost of a box of 30 PureWick catheters may be approximately $209 out-of-pocket without insurance, but buying them in bulk can save costs.
- In 2025, individuals enrolled in Medicare Part B will need to meet an annual deductible of $257 and pay a monthly premium of $185, with Medicare covering 80% of the approved treatments or services afterward.
- Learning about terms such as 'out-of-pocket cost,' 'premium,' 'deductible,' 'coinsurance,' and 'copayment' can demystify the complex world of Medicare costs and health-and-wellness products like the PureWick system, particularly for women's health.
