When a person has trouble getting to the bathroom, a doctor may prescribe a catheter. There are a wide variety of medical conditions that warrant the use of this piece of durable medical equipment. Your doctor may recommend one for the following reasons:
- Incontinence – leakage or an inability to control urinary function
- Urinary retention – the inability to empty your bladder fully
- Prostate or genital surgery
- A medical condition that leads to low or no mobility, like multiple sclerosis or a spinal cord injury
What is a catheter?
Catheters are incontinence supplies. They are tubes that are placed in patients' bodies to drain the bladder of urine. These devices can come in a variety of sizes and can be made from latex, silicone or other medical-grade materials. Your doctor will generally select the smallest catheter possible. The tube is typically connected to a reservoir. There are two kinds of these containers: leg bags are attached to the limb by an elastic band, and larger drainage basins are often made of hard plastic and are for overnight use.
There are three basic varieties of catheters:
- A foley is made of soft, flexible plastic or rubber and is meant for long-term use.
- Straight catheters are less flexible and meant for short-term usage.
- Coude tip catheters are specifically for men and are generally used when there is a scar or lesion present.
In addition, catheters can be divided into three basic categories:
- Indwelling types are left in the bladder and collect urine in an attached bag. They can be used for any length of time.
- Intermittent catheters are used periodically when needed and removed after urine flow has stopped.
- Condom catheters do not involve inserting a tube into the body. Instead, a condom-like device covers the penis. A tube connected to the device that drains the urine into a bag. It is often used on elderly men who suffer from dementia or other patients who may try removing the catheter themselves.
There are some risks involved in wearing a catheter. For instance, some people develop bladder stones and urinary tract infections. There's also chance of damage to the kidney, blood infection and urethral injuries.
Does Medicare cover my catheter?
Medicare does cover the cost of catheters and other urological supplies, however, it varies by location. Some states do not consider specific types of catheters medically necessary. For instance, a beneficiary in one city may qualify for coverage of a condom catheter, while someone in another location might not.
How do I qualify for coverage?
To qualify for coverage of a catheter, you must have a doctor's order for the device. Your physician should specify on the prescription that you have a condition for which a catheter is medically necessary. Additionally, make sure that your health care provider notes which types of catheter you require.
How much will a catheter cost?
Medicare Part B pays for 80 percent of the cost of your catheter. That leaves you with 20 percent of the price of the device. The cost varies by type of catheter and supplier. Disposable varieties can cost as little as 50 cents and are sold in bulk, whereas a reusable catheter generally costs more, often ranging from $7 to $12.
Where do I get a catheter?
You can buy catheters through durable medical equipment suppliers and wholesalers. Many pharmacies and retail stores also carry these devices. When purchasing yours, be sure to go through a supplier that is an approved contractor with the national health care program. Otherwise, you may end up having to pay for the full price of the catheter or more than expected.