Medicare coverage for PureWick external catheters: A query on whether government-funded healthcare for seniors includes these medical devices.
Managing Incontinence with a Modern Twist: PureWick for Females
Say goodbye to traditional methods of handling incontinence, as the innovative PureWick system is here! Designed specifically for women, this system is perfect for usage during sleep or rest.
The PureWick system consists of an external catheter, extending from the vulva to the buttocks, and a tube connected to a collection container that can be positioned on a nightstand or table.
In 2024, thanks to a ruling by the Centers for Medicare & Medicaid Services (CMS), Medicare began covering the PureWick system under the durable medical equipment (DME) benefit of Part B.
Navigating Gender and Sex
Gender and sex exist on a spectrum. In this article, we will use the terms "male," "female," or both to refer to sex assigned at birth. Learn more.
When Does Medicare Cover PureWick External Catheters?
Medicare Part B offers coverage for DME, including essential medical items like oxygen supplies, walkers, and hospital beds. To qualify, a Medicare-enrolled individual needs a prescription from a Medicare-enrolled doctor or healthcare professional for home use.
DME may include external catheters as alternatives to indwelling catheters for individuals with permanent urinary incontinence. As of 2024, Medicare covers the PureWick system under this category. However, Medicare will not cover the system if an individual already has an indwelling catheter, and for female catheters, Medicare limits usage to no more than one metal cup or pouch per week. In a hospital setting, catheters are covered by Part A.
How Much Does Medicare Pay for PureWick?
On the manufacturer's website, a box of 30 catheters costs approximately $209 for those paying out of pocket without insurance. Purchasing in bulk can result in savings.
As of 2025, those enrolled in Medicare Part B must meet the annual deductible of $257 and pay a monthly premium of $185. Once these conditions are met, Part B will cover 80% of approved treatments or services. For Part A, most people are exempt from paying a premium but must meet a deductible of $1,676, after which Part A will cover their hospital stay and any necessary medical devices during that period fully for the first 60 days. Medicare Advantage (Part C) plans, which must provide the same benefits as Original Medicare, offer premiums, deductibles, and coinsurance that vary depending on the plan.
glossary of Medicare terms
- Out-of-pocket cost: The amount a person must pay for care when Medicare does not pay the total amount or offer coverage. This includes deductibles, coinsurance, copayments, and premiums.
- Premium: The amount of money a person pays each month for Medicare coverage.
- Deductible: An annual amount a person must spend out of pocket within a specific period before Medicare starts funding their treatments.
- Coinsurance: The percentage of treatment costs a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: A fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
- The innovative PureWick system, designed for female health systems, is an external catheter device that can help manage incontinence, particularly during sleep or rest.
- Medicare Part B, under the durable medical equipment (DME) benefit, now covers the PureWick system due to a 2024 ruling by the Centers for Medicare & Medicaid Services (CMS).
- To qualify for Medicare coverage, a prescription from a Medicare-enrolled doctor or healthcare professional is required for home use.
- PureWick may be considered as an alternative to indwelling catheters for those with permanent urinary incontinence, but Medicare will not cover the system if an individual already has an indwelling catheter and limits usage to one metal cup or pouch per week for females.
- Although the cost of a box of 30 catheters on the manufacturer's website is approximately $209, purchasing in bulk can result in savings for those without insurance.
- For those enrolled in Medicare Part B, out-of-pocket costs include deductibles, coinsurance, and copayments, while premiums must be paid each month for coverage.
