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Medicare Policy for Ostomy Supplies Improved
The United ostomy Association (UOA) Is pleased to Inform you that the four
Durable Medical Equipment Regional Carriers (DMERCs) have adopted
recommendations from the ILIOA for Improving their Medicare ostomy policy.
The specific Improvements are listed below:
Utilization of Supplies
The DIVIERCs have increased the number of items you can use per month
without the need for additional documentation for medical justification.
The monthly utilization guidelines have changes as follows:
- Drainable pouches have increased from up to 10 to up to 20/month
- Urinary pouches have Increased from up to 10 to up to 20/month
- Closed pouches have increased from up to 31 to up to 60/month
- Irrigation sleeves have increased from I to up to 4/month
- Solid skin barriers and skin barriers with flange have increased from up
to 10 to up to 20/month You can now also use one ostomy belt per month.
Basic documentation continues to be required for the dispensing of supplies.
This continues to be a doctor's order or prescription.
* If you have a colostomy and choose to use closed pouches to manage your
ostomy, you do not need to provide any additional medical justification for
the use of closed pouches.
* If you still need more supplies than the new increased guideline amounts,
the DMERCs have streamlined the process for providing the required medical
- You will simply be required to obtain a letter from your doctor explaining
the medical reason for needing more supplies than the usual maximum
quantities as listed above. Your supplier does not need to routinely submit
this letter with your claim, but must keep it on file in your records as a
copy may be requested in the future by the DIVIERC.
The changes took effect for the whole country on October 1, 2000.
Remember: You are entitled to obtain 1, 2, or 3 months supply at a time
if you live at home and 1 months supply if you are in a nursing home.
* Please share this information with your supplier.
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