Please be advised:
One of the unintended consequences of Affordable Care Act is that insurance companies are using the law to exclude some urological supplies. As of January 1, 2014, United Healthcare no longer covers catheters and other urological supplies on many of their policies, but they haven’t alerted their customers to this change. Don’t just assume that all of your supplies will continue to be covered. Please be proactive and contact your HR department or insurance agent to confirm that everything you currently use is still covered by your plan. It is likely that other insurance companies may follow this path going forward as long as no legal action stops United Healthcare from this cost-saving maneuver.
If you have been affected by these changes and your urological supplies are no longer covered, we may be able to help with the appeals process to grant you a waiver. Give us a call at 631-269-6233 to see how we can help you out if you are unsure. Don’t wait before it’s too late. Get the care you deserve.
Additionally, Medicare has begun a new chapter focusing on cutting costs and as such is requiring detailed documentation in your medical record in order for payment of your catheterization supplies. Medicare is shifting the responsibility of providing proof of medical necessity to the beneficiary. It is vital that you speak with your doctor often, at least once per year, and ensure that your medical record accurately describes your condition as well as your continued use of sterile intermittent catheters. Although your physical condition may not have changed, your doctor must still provide proof that you require intermittent catheters to comply. Without this proper documentation, Medicare will not pay for your urological supplies. Simply put, it doesn’t seem to matter anymore if you need the supplies, only if you can document it.
Just a short note to personally thank you for the years of fine catheter service you have given me. It’s too easy to overlook someone who does everything right the first time; that’s a rare experience.