Medicaid Coverage for Diapers and Other Incontinence Supplies

Medicaid Coverage for Diapers and Other Incontinence Supplies

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Medicaid can pay for diapers for your child

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 underpads, liners, disposable gloves and other related items.

Coverage starts at Age 4: Wisconsin Medicaid will only pay for diapers and other related supplies for children ages 4 and older. It’s typical for children under 4 to be potty trained 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 will deliver diapers and other incontinence supplies to your home every month.

J&B Medical Supply                                                                                                                                                                                                                                                                                   
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Starting the Medicaid Process

1st:  Have your child’s primary care provider write a prescription for diapers and/or other incontinence supplies saying that they are medically necessary.

2nd:  Contact J&B Medical Supply 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).

3rd:  J&B Medical Supply 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.

During the intake tell them about your concerns, like needing extra absorbency at night or chafing and irritation with certain products. And, try to be as specific as possible when you explain what works best for your child.

What Supplies Can We Order from J&B? Some supplies covered by Medicaid and available from J&B include: diapers, liners, disposable changing pads, gloves, barrier creams, ointments and catheters.

Which Brands or Types of Diapers are Available? J&B’s contract with Wisconsin Medicaid offers only certain manufacturers and products to families. They may not have the specific brand of diaper your child has used in the past, but they have a lot of options.

What About Wipes? J&B does not supply wipes because they can’t bill Medicaid for them. Instead, wipes can be covered with your child’s Medicaid card through HealthCheck Other Services (HCOS). For more information on HCOS read our Family Voices Fact Sheet at familyvoiceswi.org/resource-library. Your pharmacy or home health provider will need to bill using Medicaid’s HCOS. Contact your Regional Center if you have questions.

Your child’s Children’s Long-Term Support (CLTS) funds may also be used to cover wipes. Talk with your child’s service coordinator for more information.                                                       

Can J&B 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 Waiver Funds to Pay for Diapers? In general, no. Diapers and incontinence supplies are a Medicaid card covered service, so CLTS waiver 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 wipes that aren’t available from J&B.

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. If you cannot resolve the problem with J&B, contact ForwardHealth Member Services, 800.362.3002.

Not Enough or Too Many Diapers? Contact J&B if they are delivering too many or not enough products. They can put your order on hold for a few months or get approval to send you more diapers, gloves or other supplies.

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