Inquiring about Medicare coverage for PureWick external catheters?
Reimagine the Manageable Mess of Incontinence with PureWick
Get a handle on incontinence with style and convenience, thanks to the cutting-edge PureWick system, a sleep-friendly and cozy solution tailored for females. This innovative system comes with an external catheter that extends from the vulva to the buttocks, connected to a tube leading to a collection container for easy placement on a bedside table or table.
Some excellent news for those in need of support: Starting in 2024, Medicare's Centers for Medicare & Medicaid Services (CMS) declared that the PureWick system can be covered under the durable medical equipment (DME) benefits of Part B.
Before we dive in, remember that sex and gender are on a spectrum. This article uses the terms "male," "female," or both to refer to sex assigned at birth Learn more.
PureWick: When Does Medicare Step In?
Medicare Part B levies their coverage on essential DME, encompassing items like oxygen supplies, walkers, and hospital beds. To receive a qualified device, a Medicare-enrolled individual must secure a prescription from a Medicare-approved doctor or healthcare provider for home use.
As of 2024, the DME category now includes external catheters as alternatives to indwelling catheters for individuals battling permanent urinary incontinence. However, Medicare won't cover it if an individual already has an indwelling catheter. For females, coverage is capped at one metal cup or pouch per week. In a hospital setting, catheters are typically covered by Part A.
The Price Tag: What Does Medicare Pay for PureWick?
As per the manufacturer's website, a box of 30 catheters comes with a price tag of approximately $209 for those paying out of pocket. Bulk purchasing can reportedly save some cash.
In 2025, Medicare Part B obliges enrollees to meet an annual deductible of $257 and a monthly premium of $185 before covering 80% of treatments. Those enrolled in Part A must frequently meet a deductible of $1,676, after which Part A will foot the bill for their hospital stay and any necessary medical devices for the initial 60 days.
Medicare Advantage (Part C) plans are private plans that offer the same benefits as Original Medicare. Premiums, deductibles, and coinsurance vary based on the plan.
Medicare Jargon Demystified
- Out-of-pocket cost: This is the amount you're on the hook for when Medicare doesn't cover the full bill. This can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the monthly fee you pay for Medicare coverage.
- Deductible: This is an annual amount you must spend out-of-pocket before Medicare starts covering your treatments.
- Coinsurance: This is the percentage of the treatment costs you must cover yourself. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed amount you pay when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
- Starting in 2024, the PureWick system, a solution for female incontinence, will be covered under the Medicare Part B's durable medical equipment (DME) benefits.
- To receive a qualified PureWick device, a Medicare-enrolled individual must secure a prescription from a Medicare-approved doctor or healthcare provider for home use.
- As of 2024, the DME category now includes external catheters as alternatives to indwelling catheters for individuals with permanent urinary incontinence.
- However, Medicare won't cover PureWick if an individual already has an indwelling catheter, and coverage is capped at one metal cup or pouch per week for females.
- According to the manufacturer's website, a box of 30 PureWick catheters costs approximately $209 for those paying out of pocket.
- In 2025, Medicare Part B enrollees are required to meet an annual deductible of $257 and a monthly premium of $185 before covering 80% of treatments like the PureWick system.
