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Medicaid Coverage for Diapers and Other Incontinence Supplies
Reviewed November 2024
Wisconsin Medicaid covers the cost of diapers and other incontinence starting when a child turns age 4. These products must be sent from J & B Medical. The medical term for diapers is incontinence supplies. This includes briefs (diapers that open on each side) and pull-up or pull-on type diapers. Incontinence supplies also include disposable under pads, liners, disposable gloves, wipes and other related items.
Coverage Starts at Age 4
Wisconsin Medicaid only pays for diapers and other related supplies for children ages 4 and older. It’s typical for children under 4 to be potty training so Medicaid won’t cover the cost of diapers for children ages birth through 3.
Order Directly from J & B Medical Supply
J & B Medical delivers diapers and other incontinence supplies to your home every month. Note that Medicaid does NOT reimburse you for purchasing your supplies from a local retailer.
J & B Medical hours: 7:00am – 5:00pm, Monday – Friday
Phone: 866.674.5850
Website: jandbmedical.com
Starting the Medicaid Process
- Have your child’s primary care provider write a prescription for diapers and other incontinence supplies you need. The provider must document that they are medically necessary.
- Contact J & B Medical for an intake. Be ready to give the intake staff the following information:
- Your child’s ForwardHealth card number,
- The name, phone number and address of the provider who’s prescribing the supplies,
- An estimate of the number of diapers your child uses each day, and
- Any other products you need (like liners, gloves and pads).
- J & B Medical will contact your child’s provider directly and complete the forms needed to get Medicaid approval. When J & B gets this approval, they will start delivering your child’s supplies to your home every month.
Tip for Families
Use your intake call with J & B to tell them about your concerns for your child, like needing extra absorbency at night or chafing and irritation with certain products. Be as specific as possible when you explain what works best.
What Supplies Can We Order from J & B Medical?
Examples of incontinence supplies covered by Medicaid, and available from J&B, include diapers, liners, disposable changing pads, gloves, wipes, barrier creams, ointments and catheters.
Which Brands or Types of Diapers are Available?
J & B Medical’s contract with Wisconsin Medicaid offers only certain manufacturers and products. They may not have the specific brand of diaper your child has used in the past, but they have a lot of options.
Can J & B Medical Send Me Samples?
Yes. After your child’s intake, or at any time you find the diapers are not working well for your child, you can request samples of different products.
Can I Use CLTS Funds to Pay for Diapers?
In general, no. Diapers and incontinence supplies are a Medicaid card covered service, so CLTS funds cannot be used. However, CLTS funds may be used for other supplies related to your child’s personal care needs, like reusable pads, adaptive clothing or supplies not covered by their ForwardHealth card.
What if the Products Don’t Work for My Child?
The first step is to contact J & B directly if the diapers or other supplies don’t work well for your child. Ask to speak with a nurse and explain the problem. J & B may have another product that meets the needs of your child.
Tip for Families
Additional types of diapers may be available from J & B Medical with a prior authorization request from your child’s doctor.
Medicaid Can Now Pay for Incontinence Wipes
Wisconsin Medicaid now covers wipes as part of the incontinence supply contract with J&B Medical. A new nursing assessment and prescription will be needed to get coverage for wipes. The nursing assessment will decide the number of wipes to be covered per individual, based on medical necessity.
Starting in December, J&B Medical will begin notifying members of this change by including a flyer in their shipments. Wisconsin Medicaid will also be attending several forums and council meetings to share information about this change with its partners. If you have questions about this rollout, please call J&B Medical at (800) 737-0045 or ForwardHealth Member Services at (800) 362-3002.
Not Enough or Too Many Diapers?
Contact J & B if they are delivering the wrong amount of diapers or other supplies. They can put your order on hold for a few months or get approval to send you more diapers, gloves or other supplies.
What if I’m not Receiving My Shipment?
We have heard from families that their delivery was delayed, or a shipment from J & B Medical was missed. We encourage families to closely track when their delivery is expected each month. If a few days go by and you have not received your supplies, immediately call J & B Medical at 866.674.5850. There could be an insurance coverage issue, or they incorrectly stopped your shipment. Be persistent and ask to speak to the nurse, or the billing department to confirm that your child’s Medicaid coverage has not changed.
If you cannot resolve the problem with J & B Medical, contact ForwardHealth Member Services, 800.362.3002. You can also contact Disability Rights Wisconsin to report your issues at 800.928.8778.
INFORMATION AND RESOURCES
Wisconsin Wayfinder: Children’s Resource Network, 877-WiscWay (877-947-2929): Wisconsin Wayfinder offers families one name and phone number to find services for children with special health care needs. Wayfinder connects you to a resource guide at one of the five Children’s Resource Centers in your area.
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