Frequently Asked Questions - Incontinence Washes and Creams

1. Are incontinence washes and creams no longer covered by the Medi-Cal Program after June 30, 2009?
2. Who can still receive incontinence washes and creams after June 30, 2009?
3. I live in a skilled nursing facility, intermediate care facility, or sub acute care facility. How will this change affect my incontinence washes and creams after June 30, 2009?
4. My doctor prescribed incontinence washes and creams for me before I reach 21 years of age. Can I continue to receive these products when I turn 21?
5. My doctor prescribed incontinence washes and creams for me before July 1, 2009. Can I continue to receive these products after July 1, 2009?

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1. Are incontinence washes and creams no longer covered by the Medi-Cal Program after June 30, 2009?

Answer: Yes. Only the following persons can continue to receive incontinence washes and creams:

a. Pregnant women will receive the optional benefit if it is part of their pregnancy-related care or for services to treat a condition that may cause problems in pregnancy.

b. Children or young adults who are 20 years old and younger and receive full scope Medi-Cal.

c. People who live in a licensed nursing home such as a Skilled Nursing Facility (SNF), Intermediate Care Facility (ICF) and Sub Acute Facility.  Incontinence washes and creams are included in the facility payment and not paid separate.  An authorization is needed to obtain incontenence creams and washes for people living in an ICF-DD.

2. Who can still receive incontinence washes and creams after June 30, 2009?

Answer: Only the following persons can continue to receive incontinence washes and creams:

a. Pregnant women will receive the optional benefit if it is part of their pregnancy-related care or for services to treat a condition that may cause problems in pregnancy.

b. Children or young adults who are 20 years old and younger and receive full scope Medi-Cal.

c. People who live in a licensed nursing home such as a Skilled Nursing Facility (SNF), Intermediate Care Facility (ICF), ICF for the Developmentally Disabled (ICF-DD) and Sub Acute Facility.

Please note: As current policy states, incontinence supplies will remain a non-benefit for children under five years old. An approved Treatment Authorization Request (TAR) is needed to receive washes and creams for children under five years old.  An authorization is needed to obtain incontenence creams and washes for people living in an ICF-DD.

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3. I live in a skilled nursing facility, intermediate care facility, or sub acute care facility. How will this change affect my incontinence washes and creams after June 30, 2009?

Answer: Incontinence washes and creams are included in the daily reimbursement rate for all skilled nursing facility (nursing homes), and it will not be paid separately.  An authorization is needed to obtain incontinence creams and washes for people living in an ICF-DD.

4. My doctor prescribed incontinence washes and creams for me before I reached 21 years of age. Can I continue to receive these products when I turn 21?

Answer: Yes. Your doctor or medical supply provider must submit a Treatment Authorization Request (TAR) with a report that confirms that you have to continue the use of these products for a certain period of time. The TAR must show the start date and the finish date for using these products. Orders for “lifetime” use of incontinence cream and washes will not be accepted.

5. My doctor prescribed incontinence washes and creams for me before July 1, 2009. Can I continue to receive these products after June 30, 2009?

Answer: Yes. Your doctor or medical supply provider must submit a Treatment Authorization Request (TAR) with a report that confirms that you have to continue the use of these products for a certain period of time. The TAR must show the start date and the finish date for using these products. Orders for “lifetime” use of incontinence washes and creams will not be accepted.