The Purewick System female external catheter are a urine collection system that functions much like a catheter. However, unlike traditional catheters, Purewick System catheters work outside the body. It is designed to keep skin dry by pulling the urine from the catheter into a sealed collection canister.

Unfortunately, Medicare coverage for Purewick stopped in mid-2021, citing the relatively high cost and the desire to do more research on how effective and medically necessary the system is. Purewick catheters generally cost $16-$20 each. A pack of 30 female external catheters runs between $450 and $600. This discontinuation was discouraging and upsetting for many women who found the product highly effective.

Now that Purewick external catheters are no longer covered, there are currently no external female catheters that Medicare covers. 

Other Catheter Options

Although Original Medicare Part A and Part B do not cover Purewick catheters, other types of catheters are covered. The catheters and catheter supplies must be considered medically necessary, and your healthcare provider must also order your supply for Original Medicare to provide coverage.

Coverage depends on the type of catheter, the medical reason for it, and the type of facility where it is used. Other catheter-related medical supplies that may be covered include irrigation kits, bedside drain bags, leg bags, irrigation syringes, extension tubing, etc.

Patients with permanent or temporary urinary incontinence or urinary retention can receive catheter coverage. Medicare covers many types and styles of urinary catheters, including:

• Indwelling Catheters are for men and women. Insertion takes place through the urethra or a surgical hole in the stomach to connect with the bladder directly and allow it to drain into a bag.
• Intermittent Catheters are for men and women. This is used more part-time than full-time as needed by patients.
• Condom Catheters are only available for men. The is a sheath, and nothing is put into the urethra like the other types. The sheath allows the bladder to drain into a bag from a tube at the tip of the catheter.
• Closed System Catheters are another type of intermittent catheter. They use self-contained sterile collection bags and are pre-lubricated for easy use. These systems are more sanitary than other options because there’s no need to touch the catheter tube directly. That limits the risk of urinary tract and bladder contamination and infections.

Medicare Part A and Part B Coverage Details

Medicare Part A will cover catheters if the patient is staying in a hospital or an inpatient setting.

Medicare Part B provides coverage if it takes place in an outpatient setting or if you need them because of a permanent condition. Medicare will usually provide coverage when the catheter is considered a prosthetic device. They will also typically cover them in other situations, such as hospice care. 

Medicare Part B provides reimbursement for 80 percent of the costs of your catheters. You will pay for the remaining 20 percent as a deductible coinsurance unless you have supplemental coverage.

Medicare provides coverage for up to 35 external catheters per month for men for male patients. Medicare covers one pouch per day or a metal cup each week for women.

What About Part C Coverage?

Medicare Advantage Part C plans may provide beneficiaries coverage for Purewick catheters. These plans must cover everything Original Medicare covers. However, they will provide additional benefits as well. What they offer and the costs for these added benefits depend on your insurance plan. 

DISCLAIMER:  Medi-Solutions Insurance Agency, LLC is not affiliated or endorsed with the Social Security Administration or the Federal Medicare Program. Information is for educational purposes only and should not be construed as an offer of insurance, advice, or recommendation. The information provided is not intended as tax, financial, investment, or legal advice. Please consult legal or tax professionals for specific information regarding your individual situation.

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