Parameters for coverage
Disposable diapers and liners:
- covered for treatment of incontinence only medical need is documented by the ordering practitioner and maintained in the patient's clinical file.
- up to 250 disposable diapers and/or liners are allowed per month (provides for 8 changes per day)
- Claims for any combination of diapers and/or liners over 250 per month will be denied.
Diapers
- Size Small/Medium: 96/box
- Size Large: 72/box
- Size XL: 60/box
Chux
- 150/box
- Only allowed 300 per month