Incontinence and Medi-Cal

Medi-Cal will cover incontinence care items on a monthly basis. The doctor 1) needs to complete a CMN or make a prescription detailing the patients needs and 2) provide medical records showing that the patient is incontinent either by note or diagnosis. Due to the fraud in the industry a prescription is not sufficient by itself for the insurance to cover an item or items. The prescription authorizes what is needed while the doctors medical records (ie visit notes/soap notes/patient chart...) prove medical need and context justifying coverage. 

 

    Diapers/tabbed briefs

    Adult Pull-ups

    Underpads

    Inserts

    Cream/Wash

    Gloves *

    Wipes*

 

* Gloves and wipes may be covered with special authorization. VPC will submit a request for approval (TAR) once adequate documentation received for processing (ie CMN and Medical Notes).