Yes, Medicaid Does Cover Diapers for Adults
Jun 24, 2024![Medicaid Covers Adult Diapers](https://kajabi-storefronts-production.kajabi-cdn.com/kajabi-storefronts-production/file-uploads/blogs/2147493398/images/018ca0-8d62-6307-727e-a401ad0c681f_Blog_Post_Title_Graphic_3_.png)
For some families with loved ones with disabilities, toileting duties are a part of a caregiver's daily responsibilities. For individuals unable to use the toilet on a timed schedule or as-needed basis, the cost of adult diapers and other continence care products, like wipes, disposable gloves, and disposable underpads, can really add up. The good news is that these out-of-pocket costs (ahem, the diapers and some other supplies) are covered by Medicaid! Yes, a Medicaid health insurance program in each state does cover types of incontinence supplies for special needs and older adults for most states.
You can find digital proof of your state's Medicaid coverage documentation for free incontinence supplies by referencing the list below. While states can change their Medicaid policy at any time, it may be reassuring to know that at the time of this blog posting (June 2024), all 50 states' Medicaid insurance plans cover incontinence supplies, and some states, like Tennessee and Delaware, are beginning to expand Medicaid coverage for diapers to those under 2 years old.
Adult Diaper Medicaid Coverage
While Medicaid is a program offered by the United States federal government, those federal funds are managed by each state. Therefore, coverage for these necessary supplies depends on the individual states plan. Coverage for incontinence is not a Mandatory Medicaid Benefit or on the list of Optional Medicaid Benefits, meaning each state would need to (and has) approve these medical supplies under their type of Medicaid plan.
Diapering supplies may be listed in state Medicaid programs manual as 'Incontinence' or 'Medical Supplies' or 'Durable Medical Equipment and Supplies.' Urinary incontinence and fecal incontinence is when there is a loss of or inability to control one's urine or feces. While your loved one may need diaper supplies because they have special needs, state Medicaid plans cover these medical supplies due to medical conditions that cause incontinence, meaning the Medicaid recipients would need to show proof of their specific needs to their medical provider rather than a specific diagnosis.
For states where Medicaid covers these medical supplies, medical necessity and prior authorization from a healthcare provider is needed to access these supplies. There are also quantity limits to the prescription or program that is providing the supplies.
The need for financial assistance to pay for diapers spans more than just the diaper itself.
Coverage of incontinence products may include (consult your state Medicaid plans for exact coverage):
- Disposable diapers/Adult briefs
- Bladder control pads
- Wipes
- Disposable gloves
- Disposable underpads (a thin layer to protect the bedding and furniture when changing)
If the individual is a Medicare recipient, then incontinence supplies and adult diapers are NOT covered. It is possible to have both Medicare and Medicaid insurance benefits, and if this is the case for your loved one, then they can secure incontinence products through Mediciad to meet their individual needs.
Medicaid Coverage for Diapers for Adults by State
*This list is current as of June 2024. Coverage by state may change when states update their Medicaid services plans.
Links direct users to digital proof showing coverage through the state's Medicaid program.
- Alabama- YES
- Alaska- YES
- Arizona- YES (State Diaper Program)
- Arkansas- YES
- California- YES
- Colorado- YES
- Connecticut- YES
- Delaware- YES (see page 32-33)
- Florida- YES (see page 5)
- Georgia- YES
- Hawaii- YES (proof from provider form)
- Idaho- YES (see page 76)
- Illinois- YES
- Indiana- YES (proof from approved suppliers for providers)
- Iowa- YES (see page 30)
- Kansas- YES
- Kentucky- YES
- Louisiana- YES (see page 6)
- Maine- YES (see page 49)
- Maryland- YES (see page 87)
- Massachusetts- YES
- Michigan- YES
- Minnesota- YES
- Mississippi- YES (see page 88)
- Missouri- YES
- Montana- YES
- Nebraska- YES
- Nevada- YES
- New Hampshire- YES
- New Jersey- YES (see page 44)
- New Mexico- YES (see page 7)
- New York- YES
- North Carolina- YES (see page 21)
- North Dakota- YES
- Ohio- YES
- Oklahoma- YES
- Oregon- YES
- Pennsylvania- YES
- Rhode Island- YES
- South Carolina- YES
- South Dakota- YES
- Tennessee- YES (see page 5)
- Texas- YES (see page 66)
- Utah- YES (see page 9)
- Vermont- YES
- Virginia- YES (proof from provider manual)
- Washington- YES (proof from provider form)
- West Virginia- YES
- Wisconsin- YES
- Wyoming- YES (see page 47)
Since I live and work in Illinois, I'm most familiar with the benefits of this state. If you reside in Illinois and are looking for other ways to make ends meet, including cash payments and options for living outside the family home, check out my blog about What’s Available to Help Disabled Young Adults in Illinois: Funding, Services, and Supports.
You can also grab my step-by-step guide to applying for Medicaid. A must-have for those who want to make sense of the confusing application process!
Apply for Medicaid
If you read that your state offers Medicaid coverage for diapers and are interested in this health insurance benefit, you'll need to apply. The best way to get started is to visit your state's Medicaid benefits website. A simple Google search of '(state) Medicaid Apply' should bring up your state's website to begin the process.
If you live in Illinois and have special needs, check out my Medicaid Benefits Guide for step-by-step guidance with accessing this benefit.
If your loved one currently has coverage through available family member private insurance plans, they can still apply and be approved. If they are over 18 years old and earning minimal to zero wages from a competitive job, then they can apply as Medicaid is a health insurance benefit specifically for low-income adults.
Also, if your loved one was approved for Supplemental Security Income, or SSI, because of their disability, then they are automatically approved for Medicaid. Many states will automatically enroll people who have been approved for SSI, but that isn't the case for all states. So, if your state didn't automatically enroll your loved one after they were approved for SSI, then complete the application and choose the Medicaid plan that this best for the individual.
For individuals with autism, there are additional ways to help cover the cost of daily living expenses. I share 7 other Disability Benefits for Adults with Autism that can help offset the cost of living expenses, housing, care, and more.
Other Options for Getting Diapers
While the National Diaper Bank Network's main audience is infants and babies, they recognize the need for adult diapers and direct those in need to their Member Diaper Banks, where you can search by state.
Simon Foundation for Continence
The Simon Foundation for Continence has a smaller reach than National Diaper Bank Network, but there may be a local bank that provides adult-size diapers close enough to you or your family network that could access their resources.
While these diapers won't be free, they will come at a reduced cost compared to big-box stores, as donation-based stores are selling what they receive from the local community. I have seen these type of incontinence supplies at donation-based stores and flea markets. Also, consider local Facebook 'Buy Nothing' Groups or the Buy Nothing Project to connect with locals who may have one-time donations to offer.
Community-Based Services
Google 'Adult Diaper (zipcode)' to see what community-based services may have free adult diapers. Churches, support organizations, and your county's public healthcare program may have banks of diapers, wipes, care products, or protective underwear available for those who qualify.
For funds to take care of the rest of the costs associated with incontinence (like adaptive clothing), consider using another federal government funding option, Social Security Administration's Supplemental Security Income, or SSI, if the individual is disabled.