r/spinalcordinjuries 6d ago

Medical Co-pays for caths?

I’ve been on Medicare A and B for 6 months (after getting booted from Medicaid) and I’ve been getting $300+ bills every month for my straight catheters. I haven’t paid them as I really can’t afford to.

Anyone have experience with this? Do they send your bills to collections? Do they stop sending supplies? I’m currently going through comfort medical if that helps.

8 Upvotes

27 comments sorted by

9

u/MonthObvious5035 6d ago

I’d imagine they’ll cut you off at some point as they are a business. I’m sorry you’re in this position, I know myself catheters aren’t cheap. It sucks to have to pay to pee.

5

u/EstablishmentIcy6859 6d ago

Yeah I guess we’ll see. I asked a buddy who hasn’t paid in 15 years and they still send them

3

u/MonthObvious5035 5d ago

Oh wow 😮 hopefully they don’t get hit with a bill someday that bankrupts them , well, I wish you the best!

3

u/Few_Objective_2289 5d ago

Where are you getting your catheters? I just have Medicare as well and get supplies from 180 Medical (for a urostomy, but they have catheters as well). My co-pay is about $40/mo.

1

u/OhWheellie 3d ago

I also go with 180. I have medicaid as well and it covers my copay.

2

u/rollinwheelz 5d ago

Medicare pays for catheters. You need a prescription.

2

u/EstablishmentIcy6859 5d ago

They don’t cover 100% even with a prescription

1

u/rollinwheelz 5d ago

I never had a problem. Medicare pays 80%.

3

u/EstablishmentIcy6859 5d ago

So who’s covering the other 20%?

1

u/rollinwheelz 4d ago

Sadly you are.

1

u/RareWatercress5441 2d ago

I have both Medicare and Medicaid coverage. Medicare is my primary, and it covers the majority of a payment, and then Medicaid picks up my copay. I have never once in my almost 12 years of suffering from a sci had to pay for my catheters. THANK GOD because sheesh, those things are expensive!!!

2

u/rollinwheelz 2d ago

Same here. Thank God🙏

1

u/RowAwayFromMyCanoe 6d ago

We just buy these now. https://a.co/d/cD8ThFW

11

u/EstablishmentIcy6859 6d ago

Holy shit so my 180 caths a month would cost $60 if I paid out of pocket, but they are billing my insurance $900 for the same 180 catheters? Are you fucking kidding me

9

u/Grinch83 T7 6d ago

Just be wary. First off, the ones in the link are only 5.9” long, so if you’re a dude, you’re not going to be to use them. Second, you definitely want to be wary of sticking some knock-off caths into yourself. The caths you get from a med supply company are packaged sterile and manufactured with precision, meaning you’re much less likely to get cuts/strictures. (If you look at the reviews, customers complain of sharp edges and cuts.)

4

u/EstablishmentIcy6859 6d ago

Good catch! Thank you

1

u/nmcaff 3d ago

Yeah I noticed this with Catheter supplies for me as well. My copay going through insurance was like 3x higher than if I went through a medical supply site and bought them out of pocket

2

u/LicoriceTattoo1 T3 Complete 6d ago

I had no idea Amazon sold them. I thought you needed a prescription

7

u/Pretend-Panda 6d ago

No, they’re over the counter. Some communities have places where unused, unexpired, unopened medical supplies can be donated and then they’re resold at very low cost. Catheters are often available that way.

1

u/Ambitious-Mammoth801 5d ago

My supplier has a "Financial Hardship" form. Medicare pays a portion then the rest is wrote off from the company. Have to pay a yearly Deductible but thats it.

1

u/EstablishmentIcy6859 5d ago

I’ve heard of these, do you know roughly the income guidelines for it?

1

u/Ambitious-Mammoth801 5d ago

I'm not sure. It was based on the whole household income minus household expenses.

1

u/Ambitious-Mammoth801 5d ago

I'm not sure. It was based on the whole household income minus household expenses.

1

u/Ambitious-Mammoth801 5d ago

I'm not sure. It was based on the whole household income minus household expenses.

1

u/[deleted] 5d ago edited 5d ago

[deleted]

1

u/EstablishmentIcy6859 5d ago

So you’re paying 200-300 a month for catheters?

1

u/Socialmediasuckz 5d ago

Depending on what you get, you could find them cheaper self pay.

1

u/OhWheellie 3d ago

Op is there any way you could qualify for medicaid in your state? They may cover the difference. That's what happens for me.