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Support for dealing with incontinence
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PostPosted: Sat Apr 26, 2014 1:08 pm 
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Joined: Sat Apr 26, 2014 10:53 am
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Location: Valencia, Spain
Hello,

I´d like to know how incontinence is helped by the health systems in the different countries, so I explain how it works here in Spain and expect your posts to know how it is in the place you live.

Here there is a national health insurance public. Means that if you are spanish or tourist or even illegal you have attention in hospital. The medicines are payed in part by the system (unless you have a private one) and it´s depending of the money you earn per year, as it follows: less than 20.000€ 60%, between 20.000 and 100.000€ 50%, more than 100.000€ 40%. If you are unemployed with no help from the Government, or retired, or disabled higher than 65% and with government aid (means you don´t work for more than 5.000€ a year, it´s my actual situation, I´m 66%) then you haven´t to pay anything. Sorry! Recently they changed law and now retired pay 10% with a limit of 40€ each month. About the diapers: there are just complete briefs and big pads for severe incontinence (for example, tena flex, slip and pad) but just until the medium level, I mean for example you can have tena plus or super reemboursed, but not tena maxi. And in fact, as it isn´t in the public health catalog, it´s not sold in spain. I Know because two years ago I went working to disneyland paris and in France yes you can buy them, but there is ANY DIAPER paid by the health public system, even if you´re disabled a 99%, it´s not paid for anyone. In fact if you´re in hospital or someone bring you the diapers you need or they re sell you the diapers more expensive :| (no comments). That´s the french situation (and one of the reasons that made me return to spain leaving the job and the country). But let´s come back here to Spain, as I said those diapers Like tena slip flex and pads are in catalog but just arriving to the medium absorbency (and price :roll: ) rate. The same with all the other brands sold here. But, and this is important, to have them prescribed you must have an objective medical cause, for example, I have spinal injury, and it´s proved by an electromiogram, the same with the nervous system illnesses, in mental diseases, too, if there´s a doctor that says so, you have them, but IF THERE´S NO OBJECTIVE CAUSE (for example, an enuresis can´t be phisically proved) them you´ll have to pay the 100% if need them :cry: . And as I explained before, if you are disabled more than 65% and have them prescribed you don´t pay a single cent earning less than 5.000 € year with gov. pay apart, if you´re disabled and earn less than 20.000€ you pay 40%, 100.000% 50%, and more income than 100.000 (and no private insurance) 60%.

What´s the situation in the US, and the other countries of all you members?? I think Here we´re lucky of having a such generous health public insurance, even if we pay it with very high taxes, the matter is that it´s becoming each time more unfair. The public is for people with less resources!! How understand that the guy that wins 20 thousand euros year pays the same that the guy that wins 100?? and why the (rich) guy that wins more than 100 pays 60% if he should pay the 100%? Because his taxes are equal for him that for me that for the middle earning guy!!! And he can have a private health center (where he will be also treated better, that´s reality!) What do you think about it? But forgive me, give me your opinion just if you want, but plaese share with us what your insurance does for your health diseases? And for the incontinence? does it pay you the diapers? Is it public or private? Thanks very much for your cooperation but I just started this post because I think it´s interesting and it concerns to absolutely all of us, and hope I´ve explained the spaniards (and neighbour country) situation well enough, so you can have an aproximate idea of how things work here in Spain and Europe for us diaper users. Thanks for your attention and wait craving your answers. My best regards, salutations form the mediterranean sea!! :wink:

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PostPosted: Sat Apr 26, 2014 1:23 pm 
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Joined: Sat Apr 26, 2014 10:53 am
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Location: Valencia, Spain
Hi again, of course that apart of telling us how it works were you belong, I´d also like if this (what we have here seems you fair, normal or unfair, but as I said before just if you want to give your opinion. It´s because I think it´s good to know with a constructive critic what´s good and bad of what we have of persons of foreign countries because you´ll be completely objective about something relative to a country you don´t know. Thanks again! :)

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PostPosted: Sat Apr 26, 2014 6:27 pm 
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Joined: Sun Jun 23, 2013 10:22 pm
Posts: 497
Location: Western North Carolina
Hello Lord D.

I can only testify for Blue Cross/Blue Shield here in NC in the US. They pay 0% for incontinence products. I have heard if you pay for the high end coverage, it will but I can't afford that. Now if you get on Medicare, then you can but from what I have seen, you ccan only get the cheap brands like Wing.
Also If you are a veteran the VA will get them or give you an allowance to get what you want.

Maybe some of the other members here will be able to morer.

rna


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PostPosted: Sat Apr 26, 2014 8:05 pm 
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Location: "Wet Coast" B.C., Canada
My extended medical coverage only covers drainage systems, like foleys and external catheters and leg bags, which I do use, but not all that often. I guess any little bit helps! Puffy

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PostPosted: Sat Apr 26, 2014 8:10 pm 
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Joined: Sat Apr 26, 2014 10:53 am
Posts: 80
Location: Valencia, Spain
mmm, I see. I can suppose that if it works that way in North Carolina should be the same in the rest of the United States? Or I´m wrong and there differences between the states?

If I haven´t explained myself clearly enough I´ll try again, hope this time I´m more understandable. Here in Spain (and it´s the same way for all the country, but NOT EUROPE. As I said before in France where I worked in disneyland Paris it´s completly different, there´s no way you have reimbursed a single cent of diapers of any kind, even if you have the worst disablity possible. And France is just here at the other side of the border, I mean imagine how different can be in Sweden or Finland for example, and it´s Europe too. But a friend of mine that studied in England and she´s in whaeelchair told me there yes they pay you some diapers. So here in each country the thing go it´s way, but I´m trying to explain how it does here in Spain)if you don´t have a private insurance what means you´re in the public health system, and you have bladder or bowel incontinence that can be MEDICALLY DEMONSTRATED (that´s important) then you can choose the kind of diapers you need in the catalog. Of Tena you´ve got all excepting the Maxi, and all the other brands, the cheap and the expensive, the good and the bad :wink: . So, one time you have proved with diagnose your incontinence you choose your kind. Apart of Tena there is the Arbora&Ausonia ones, the Molicare, the Incopack, Tena and like seven or eight more marks, and there´s the pads, and the briefs but not the protective underwear and neither the little pads for light urine loss. As you see, they just pay for the cases of heavy incontinence. If you don´t wet too much, you must pay.

Expecting that I left clear which are the cases where you can have your diapers or pads paid and what ones you can choose, now let´s see how much (or nothing) you are paying of it depending on 2 things: first is your income amount and second is your disability. And this I explain now isn´t just for diapers if you have them diagnosed or prescribed by a doctor but for almost all the drugs the doctor can prescribe to you sold on pharmacy. I´m doing a scheme:

Less than 20.000€/year: you pay 40% of the price
Between 20.000€ to 100.000€/year: you pay 50% of price
More than 100.000€/year: 60% price.

And if you are retired you pay 10% with maximum of 40 € month.

Disabled with degree superior of 65%: you don´t pay at all. And recently the unemployed without subsidy don´t pay neither. That means that when you go to the pharmacy with your prescription you take your diapers or pills and don´t pay, or pay 40%, 50 or 60% in the cases exposed before. I said that after my accident they examined my sequels and gave me a 66% with reduced mobility (that´s basically the parking card and some helps for adapting cars and buying) so now I have the diapers I need free. Before I had the disability I paid 40%. And when I was a youngster and wetted the bed I paid 100%. it´s important to note that everything I exposed is just if you DON´T HAVE PRIVATE HEALTH INSURANCE, cause if you do, it´s what the enterprise pays and each one is different, but the public is not too bad as you see.

I wanted to talk about this because I´m interested in learning how it works in other countries and also to hear the opinions of what we have here. Why? I´m a curious person, and travelled a bit around Europe and America but as tourist you can´t have an image of how´s really life (in this case for incontinent or disabled people) and I´d like to know the situation there and to know your point of view too. I know our system isn´t perfect at all, but has it´s good things, specially that the person with less possibilities have a minimum garanteed of medication or hospital if needed. But there´s some critical aspects too. Hope know I made it extense and understandable enough for you to give me your opinion and compare with yours if you want. Thanks anticipated, I truly appreciate your comments. Salutations to all

Duque

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PostPosted: Sat Apr 26, 2014 8:35 pm 
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Joined: Sat Apr 26, 2014 10:53 am
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Location: Valencia, Spain
and thanks puffy and rope for your posts, of course any help is good, that´s why I ran away from disney´s paris job when I saw that from my salary (not too generous as you could imagine) I´d have to pay 150€ every month just in diapers! Even if I had the luxury of using tena maxi, thing that here is impossible. In seven months I spent there I hadn´t any leakage in pants or sheets and using just 2 per day, one day one night. I couldn´t do anyway else in fact because I worked 10 hours in a run!! But here I have the tena super free, that´s the next Tena slip in absorbency and even if I can´t use just 2 day and I need more changes and sometimes I wet pants or bed I prefer that to paying the maxis and using less!! But don´t think it was the only reason that I left France but truly was the main one. Compared to Spain the so-called "public health" was terrifing! Just to see a doctor for any reason was 25€, in the health center they told me that there I wasn´t disabled until I had been examined for the french disability center and approved...and all for nothing!! Cause I would pay my medication, diapers, doctors and hospital anyway!! So why the f... would I want the french disability? And I study Law and in the european comunity a disability is supposed to be worth in all the shengen countries!! But not France at least. I was wrong. That´s why I left, because it was everything like that.

answering to puffy here of course that catheters and urina bags are reimbursed with the rules I exposed before ( coloplast collectors, bags, etc.) and that´why I think it´s very lucky that here just for the fact of being a citizen disabled incontinent you have the right to this help, but knowing it has its weaknesses.

It´s a pleasure to share opinions and learn things with you guys. Hope more people encourage to write here and talk about our insurances and everything. But being my first day I´m having a look in the rest of the forum to see if there somewhere I can contribute. Very thankful and until the next post!! cheers. :D

Duque

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PostPosted: Sun Apr 27, 2014 3:15 pm 
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Right now, and for the past few years, medical insurance has been extremely controversial in the United States. The United States is one big country; many of our states are equal to or larger in area and population than any of several European nations. In many policy areas our states are quasi-independent, and several of our states have chosen not to participate in our federal health insurance program. We can only guess about how this will shake out in the future, and what influence this controversy will have on health care for incontinents and their medical requirements.


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PostPosted: Mon Apr 28, 2014 7:26 am 
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Joined: Mon Jul 06, 2009 1:29 pm
Posts: 120
I was forced to the new American ACA & my provider is Blue Cross. Durable medical goods such as catheters & attachments are covered AFTER the deductible is met. I'll never reach the deductible. I've been using diapers for years now but need to cut costs & the external catheters are much less expensive but I have moments with bowel incontinence & while I've had no recent flare ups I know it's going to happen. I'm not sure how at this point to handle it. To use both diaper & external catheter is silly & actually increases my cost. I've thought about some of those anal plug but I'm still unsure about that. Any ideas?


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PostPosted: Mon Apr 28, 2014 3:04 pm 
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Joined: Fri Sep 13, 2013 12:40 am
Posts: 15
I have McLaren Medicaid insurance and it covers my incontinence products. I got a script from my doctor and my insurance pays for all of it from my provider, which is Edgepark. I'm very pleased with the selection I'm able to get from my provider. Each month I'm able to get 20 bags of Abena abri-form x-plus (Plastic backed version, the #4168 ones), with a couple bags of boosters and underpads that doesn't cost me anything which is nice because paying out of pocket for me would make a major dent in my wallet. If I were to get 20 bags per month with out of pocket money say from xpmedical.com, with a case being 3 bags of 12 at $60 for large, with each month getting 20 bags, that would be almost 7 cases..so $60x7=$420. I'm definetly happy my insurance covers all that, and I recommend checking into insurance covering incontinence supplies.

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PostPosted: Tue Apr 29, 2014 12:14 am 
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Location: "Wet Coast" B.C., Canada
Holey moley, 20 bags a month? Do you use that many, I would guess not, even if you wore 24/7, and changed 5 times a day, nice to have that coverage though! :) Puffy

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