USI says Medicare plan choice can affect PureWick access

As Medicare’s Annual Enrollment Period nears, Urological Supplies, Inc. is urging beneficiaries who use the BD PureWick urine collection system to check whether their plan covers the device through an in-network supplier. The company says plan choice can affect access, prior authorization and out-of-pocket costs starting Jan. 1, 2027.

Why it matters: - Medicare plan selection can change whether a beneficiary can keep using the BD® PureWick® urine collection system with the same supplier and coverage terms. - The choice can affect network access, prior authorization requirements and the amount a patient pays for durable medical equipment. - Patients who wait until after enrollment can face coverage changes when the new plan year starts on Jan. 1, 2027.

What happened: - Urological Supplies, Inc. said Medicare’s Annual Enrollment Period runs from Oct. 15 to Dec. 7. - USI is a Medicare-accredited durable medical equipment provider and an Authorized Distributor of the BD® PureWick® urine collection system. - The company is telling patients and caregivers to confirm coverage and supplier access before plan selections take effect on Jan. 1, 2027. - The BD® PureWick® urine collection system is a non-invasive, external alternative to an indwelling catheter. - Medicare covers the system under the Part B durable medical equipment benefit when a physician documents medical necessity. - The system is manufactured by Becton, Dickinson and Company.

The details: - Medicare’s Annual Enrollment Period allows most beneficiaries to change how their Medicare works for the following year. - During that window, beneficiaries can move between Original Medicare and Medicare Advantage, switch Medicare Advantage plans, and add, drop or change Medicare Part D drug coverage. - Original Medicare pays 80% of the approved amount for the BD® PureWick® urine collection system after the annual Part B deductible. - Original Medicare allows patients to use any Medicare-enrolled supplier that accepts assignment anywhere in the country. - Medicare Advantage plans must cover at least the same benefits as Original Medicare, including durable medical equipment. - Medicare Advantage plans typically manage coverage through networks, prior authorization and plan-approved suppliers, and cost-sharing varies by plan. - A Medicare Advantage member may need an in-network supplier and prior authorization for the PureWick system, while an Original Medicare patient generally has broader supplier choice. - Medicare requires durable medical equipment suppliers to be accredited and enrolled in order to bill covered items. - USI says it verifies each patient’s specific plan, works with the prescribing physician on documentation and files the claim on the patient’s behalf. - USI also says its guide explains how to get the BD® PureWick® urine collection system covered by Medicare in each state. - Medicare enrollment timing details are available at Medicare.gov or by calling 1-800-MEDICARE. - A patient can move from Medicare Advantage to Original Medicare during either enrollment window. - Changes made during the Annual Enrollment Period take effect Jan. 1. - Changes made during the Medicare Advantage Open Enrollment Period, Jan. 1 to March 31, take effect the first day of the following month. - A patient can enroll in Original Medicare by calling 1-800-MEDICARE, using Medicare.gov or contacting the current Medicare Advantage plan to disenroll. - A Medicare Supplement, or Medigap, policy can cover the 20% coinsurance that Original Medicare leaves. - Guaranteed-issue protection applies only in specific situations, including certain trial rights within the first 12 months in a Medicare Advantage plan. - Outside those windows, a Medigap insurer may use medical underwriting.

Between the lines: - The release frames supplier choice as the key issue, not just premium costs or plan branding. - For patients who rely on recurring supplies, network rules can matter as much as the benefit itself. - USI is positioning itself as a guide through a process that combines insurance rules, physician documentation and recurring delivery logistics. - Larry Vetter, vice president of Urological Supplies, said patients should compare the products they use regularly and ask which suppliers each plan allows. - Vetter also said patients should consider whether a supplier delivers on time and provides reachable customer support. - USI says it serves patients across more than 40 states and has done so for more than 15 years. - The company says it provides in-home education from licensed nurses and after-hours support. - USI says it is accredited by The Compliance Team as an Exemplary Provider.

What's next: - Beneficiaries making Medicare changes during open enrollment will see those changes start on Jan. 1, 2027. - Patients who want to keep using the PureWick system should confirm plan rules, supplier networks and prior authorization requirements before switching coverage. - USI says patients should confirm eligibility with their provider before making changes or ordering.

The bottom line: - For Medicare beneficiaries who rely on the BD® PureWick® urine collection system, the right plan may be the difference between smooth access and extra paperwork or higher costs.