Medi-Cal and Incontinence

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. 
 
Medi-Cal covers the following items:
    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).