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With proper documentation, Medicare will cover a closed system catheter. You are eligible for coverage if you have had two or more documented urinary tract infections within 12 months. Your physician must document the presence of symptoms such as increased incontinence or muscle spasms, autonomic dysreflexia, fever, pyuria (pus in the urine) or signs of infection in other organs (e.g., the kidneys or prostate), combined with a cultured bacteria count of 10,000 or higher.
You are also eligible for Medicare coverage if you have reflux (urine that backs into the kidney), or if you are immune-suppressed or pregnant. Please check with you primary doctor or urologist to obtain necessary documentation. If you need assistance in doing this, please call and one of our case managers will assist you.