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Incontinence Support Blog

What is this OAB I keep hearing about?

Posted by Andy Orrell

Aug 5, 2016 9:16:08 AM


Over Active Bladder or OAB, as it is commonly referred to, is a term that you will usually hear or read about when the topic of discussion is urinary incontinence. Whenever you see a commercial on TV for a drug that is used to treat urinary incontinence, you will usually hear about an “over active bladder”.

But, what exactly is an "Over Active Bladder," and what does it mean to you?

OAB usually describe a group of urinary symptoms, the most common of which is a sudden urge to urinate. The urge usually comes on unexpectedly with little warning and is more or less uncontrollable. The reaction to such an urge is finding a restroom quickly. Another common symptom of an OAB is having to go to the bathroom several times during the day and at night. 

Most of the time, an OAB is the result of bladder muscles contracting more frequently than normal. Bladder muscle contraction can be caused by many factors amongst which are urinary tract infections (UTI), side effects from drugs, pregnancy, illnesses such as Parkinson’s, MS, MD, MS and other neurological diseases.

With men, an OAB is a common sign of benign prostate hyperplasia (BPH), which in non medical terms is an enlarged prostate gland. When the prostate gland becomes enlarged, it exerts pressure on the tube (urethra) that carries urine from the bladder to exit…this pressure results in an urge to urinate  In addition to having an urge to go, an OAB can be accompanied by unavoidable urine leakage. When unavoidable leaking of urine occurs, an individual is considered to have “incontinence”. If your personal condition reaches the point of incontinence, it becomes necessary to take action. 

I strongly suggest that you quiz yourself to determine if there’s a possibility you have OAB. The five most relative questions to answer are given below. Be honest with yourself, when answering these five questions.

(To better clarify each question, I have offered further details below each question.)

Do you have to visit the bathroom more than 7-9 times during the day?
If you’re visiting the bathroom more frequently, and you’re noticing that some of those visits result in only several drops of urine, you may have OAB.

Are you having to rush to get to the bathroom for fear of an accident?
If rushing to the bathroom to urinate and finding that the result is a small amount of leakage, there’s a good possibility that you have an OAB accompanied by urge incontinence.

Do you have to go to the bathroom more than 3 to 4 times during the night?
This is a symptom of nocturia and is another sign of an OAB especially for men. When men have to get up several times during the night, it usually relates to an enlarged prostate gland or BPH as discussed above. Men can expect to see signs of BPH at age 50 and beyond.

When you’re away from home or at a social affair…for example, at a wedding or at the theater…do you find yourself scouting out the nearest restroom?
If you find yourself doing just that, you can be pretty certain that it’s another sign of an OAB or urge incontinence.

Are you avoiding to do things that you really enjoy doing for fear of having an accident?
If so…what’s happening is that you are actually changing your normal life style around the fear of a potential accident. Although this is likely another sign of an OAB, you should never succumb to a regression in lifestyle…that would be defeatism. which is absolutely unnecessary.

For those who find that they are, indeed, confronted with an OAB syndrome and/or urge incontinence, don’t fret, because there are several first-steps you can take that might work well for you. First and most important is that you learn how to recognize the symptoms of your personal incontinence condition. Once you understand your personal symptoms, you will be in a position to know whether or not what you are trying is working…remember…helping yourself is a trial-and-error process.

Most everyone who encounters OAB symptoms initially opt to trying absorption products such as liners or pads.  These products can cost hundreds of dollars a month and often cause sores. There is a better option. Men's Liberty is discreet, safer than adult diapers and condom catheters and can be purchased at little to no cost through Medicare and a secondary insurance.

Topics: external catheter for men, prostate cancer, insurance, incontinence, compassion, adult diapers

Why Aren’t Adult Diapers Covered by Insurance? And Why Men’s Liberty is…

Posted by Mens Liberty

Dec 8, 2015 2:55:00 PM


As you all should already know – last week we did a great new blog on how to get the best bang for your buck when paying for health insurance. And it seems to have sparked quite a discussion. And there has been one question coming to us over and over from viewers and I wanted to take a few minutes to answer it this week.

You asked: why does insurance cover Men’s Liberty but not adult diapers or pads?

It’s a great question – and it’s the topic for this week’s edition of “Understanding Your Insurance” with Men’s Liberty.


Let me start by giving you one little caveat – there are more than 35,000 different insurance plans in the US right now – so there’s no way I can tell you about each one. We’ve got to make some generalizations and then it’s up to you to look at your policy information or call your insurance company and ask one of their policy experts.

But in general, there are three main reasons for the difference in coverage.

#1:  Medicare sets the standard and most insurance companies follow their lead. Today, Medicare and Medicaid provide insurance coverage to roughly 1 in 3 Americans. That makes them a market leader – and the standard other plans are measured against. Medicare does not cover absorbent incontinence supplies, therefore most insurance companies follow their lead. Now there are some “cadillac” insurance plans out there that may cover some of these supplies but to be honest, I’ve never seen one.

Which leads us to #2: adult diaper manufacturers don’t want it to happen. Insurance coverage for any item usually requires proof of medical need and brings along medical coding, billing and documentation requirements. That is a lot of cost for the companies who would have no choice but to pass on the expense to consumers. So the cost of a pad goes up – and now you can’t buy it in CVS or Walgreens – you have to go to a doctor for a prescription. Quite simply –  if companies can sell lots more of them slightly cheaper – they STILL make more money. So it’s not in the manufacturers interests to get covered by insurance.

#3: It’s simply too expensive. Let’s do a little math – if 30 million people have urinary incontinence in the US (according to the NIH) and each of those people wears 4-6 diapers a day AND each diaper costs roughly $0.44 that is a total annual cost of $28,908,000,000 each year – i.e. nearly $29 BILLION dollars per year. That is a cost that insurance companies and insurance simply cannot afford to absorb without dramatically increasing everyone’s costs.


So with all that information – why cover Men’s Liberty? Because it’s only for men, because as manufacturers we have been through the Medicare coding verification process, because we provide the required documentation and ultimately – because the benefits outweigh the costs for men with urinary incontinence.

And before I leave you this week, I want to recommend a great video blog called Healthcare Triage. It’s run by Dr Aaron Carroll who is great at explaining all these things. He has a great blog that I’ll link in the description called “What is Health Insurance and Why Do You Need It” that’s filled with lots of great information.

Got insurance questions you need answered – email, call or let us know in the comments. 

Topics: proactive patients, Medicare, insurance

Sample - How To Post

Posted by Mens Liberty

Dec 4, 2015 3:05:00 PM


This week we’re tackling a bit of a new subject for us – home healthcare. It’s a buzz word that’s been flying around a lot lately but it’s not always clear that we all mean the same thing when we say “home health”.


So let’s start with the basics. Home healthcare is defined by the Centers for Medicare and Medicaid Services as “a wide range of health care services that can be given in your home for an illness or injury.” Some common examples of home healthcare services include: wound care for pressure sores or a surgical wound, intravenous or nutrition therapy, injections, or monitoring serious illness and unstable health status.

The logic here is that will be cheaper and more effective if we can deliver this kind of care in your home, rather than forcing people to stay in a nursing home or skilled nursing facility. And in general, that’s about right.

But those of you that read our blogs regularly know that there is a “BUT” coming. And it’s true. So here it is: home health can be a wonderful service for many people BUT most people don’t quite understand how having a home health nurse impacts their other insurance benefits. The devil really is in the details.

Basically, your home health care is provided by an agency. This agency is a private, for profit corporation which is contracted by Medicare or your insurance provider to provide care. They get a fixed daily payment for providing care and are supposed to provide all the care you need and all the medical supplies you need out of that per diem.

As a private, for profit agency, home health companies want to provide the required care the cheapest way possible. The less they spend on you, the more they get to keep in profit. Sounds like a recipe for problems, right?!

So what does that have to with us here at Men’s Liberty? That’s complicated by the joys of Medicare billing but LONG story short – according to the Center for Medicare and Medicaid Services only one group or entity can bill Medicare at a time for the same service. So we get quite a few of you all calling in for Men’s Liberty only to discover that if you are on home health then the agency has to purchase your supplies for you. Legally, we can’t bill your insurance for them!

So that is why, when anyone reaches our Care Representatives, we always ask whether or not you have someone coming out to your home to provide any medical care or services. Does that make sense? I know it didn’t make a lot of sense to me at first, but once I understood, a lot of other little bits started making sense. That’s why I wanted to share this info with you all here today. Home healthcare can be a great service for people in need, but it’s not always a simple as they might like you to think.


Still confused? Have questions about your health insurance coverage for Men’s Liberty? Give us a call at (800) 373-7006 or just leave your question in the comments and we’ll answer you right away!

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Topics: Medicare, insurance

Understanding Your Insurance

Posted by Mens Liberty

Dec 1, 2015 10:30:00 AM


 Welcome back everyone! This week we’re talking about the biggest seasonal news out there. Nope – not Christmas. It’s Open Enrollment. That’s right – in addition to turkey and mistletoe this time of year is a very special one for people looking at new health insurance options. So today, we’re adding to our ongoing blog series: “Understanding Your Insurance.” And I’d like to share a little wisdom and help you get the best value for your insurance dollars.


The #1 Rule is to make sure you understand exactly what your insurance actually covers. This will help you get value for money in your current policy and help you pick the best policy for next year.

Tip #2 is to maximize value once you’ve met your deductible.

If you’ve met your deductible, the remainder of 2015 is an ideal time for elective procedures, surgeries, appointments, etc. that your current insurance covers. That is why this time of year is exceptionally busy period for healthcare providers. Also, don’t forget that your “well visit” is fully covered by Medicare (with no out-of-pocket expenses) and most other insurance, so make sure to take advantage of this once-a-year opportunity by calling your healthcare provider immediately.

And our blog today wouldn’t be complete without some useful insurance selection tips.

While it’s always nice to get a head start in October to compare your current coverage with other options, but there’s still time to do some research. Think of insurance as a bit of a gamble for you and your insurance provider. You’re paying a set amount up front,  betting that your plan that will provide all the coverage you need & save you money;  but the insurance company is betting that you will need less coverage than you’re paying for. Sometimes you use less, sometimes more – if you’ve got the right insurance this should balance out over time.

So what is the right insurance for you?

It depends on your health needs and your financial situation. Most of you will probably be on Medicare so you need to decide what additional coverage you may want. To do this, its important to understand what Medicare does and does not cover. If you need certain services that aren’t 100% covered under Medicare Part A or Part B, you’ll most likely have to pay for part of them yourself unless you are enrolled in a:

  • Medi-gap (secondary) plan
  • Medicare Advantage plan OR a
  • Medicare Part D Prescription Drug Plan

 

Keep in mind that:

  • Even if Medicare Part A or Part B covers a service or item, you generally have to pay deductibles, coinsurance, and copayments. In general Medicare covers 80% of the expense of a covered service – so you still have to pay the other 20% which can really add up!
  • Since Medicare Advantage plans do not necessarily provide coverage equal to Medicare, they may not be right for you if you require a surgery or procedure or have a condition (diabetes, urinary incontinence, etc.) that requires ongoing therapy, treatment with a prescription or supplies. Before choosing any Advantage plan be sure to read all the exclusions in your contract. Don’t be blinded by advertisements offering $0 co-pays. If it sounds too good to be true – it probably is!

Now for you Men’s Liberty clients out there – how can you tell what insurance coverage will be provided for your incontinence supplies?

The good news is the traditional Medicare Part B covers services or supplies for diagnosing or treating medical conditions. The one-a-day gold standard in treating male urinary incontinence, Men’s Liberty external collection device, is covered. Just like with other services, Medicare covers 80% of the cost – and if you have a secondary policy that usually picks up the other 20%. That’s 100% coverage right there!

So take action now during open enrollment – and follow these simple guidelines to get the most out of your insurance coverage!

Regain Your Freedom Today! 

Topics: proactive patients, Medicare, insurance

How Do I Know if My Insurance Plan Covers Men’s Liberty?

Posted by Mens Liberty

Nov 24, 2015 11:00:00 AM


 This week we’re following up on one of our most popular series – Understanding My Insurance! This week we’re going to be talking about one of the most confusing parts of your insurance – how to know what your insurance will cover.


So first, let me start with a disclaimer. There are over thirty five thousand different insurance plans available in the US right now. There is no way I can cover all of them. The best I can do is give you some helpful guidelines and general information from our insurance experts.

First – consult your benefit book. If you’re like me, you probably got this massive booklet a few years ago, promptly tossed it in a corner and never read it. Your benefit booklet is your holy grail for information on what is covered AND what isn’t.

The downside is, it’s written in legalese – that’s the knick-name for language used by lawyers to confuse us normal people who don’t speak in tongues. But if you strip away the legal mumbo-jumbo – it will tell you whether or not something is covered.

Not sure, you can call them but you’ll be on hold for several weeks before you speak to an actual person. So your best bet is often to visit their website. Most insurance companies will let you set up an online account to access your profile. This has lots of coverage information and even better, it’s usually written in plain English!

Our second tip, especially for those of you who have Medicare, is to call 1-800-MEDICARE. They can give you lots of great information about coverage. In general, for older adults, Medicare sets the baseline for what is considered acceptable coverage. If Medicare covers it, many insurance companies will follow suit. This isn’t always the case but it can be a useful indicator.

And our third and final tip – if you’re not sure – ask us! We talk to men every day looking to try Men’s Liberty and get it covered by their insurance. We work with our distributors to do something called: insurance verification. This is where we take your information from your insurance card and check it with the insurance company online to verify your benefits for Men’s Liberty. Men’s Liberty is covered under a particular code – so that’s what we look for. Once we’ve verified your insurance, we’ll call and tell you if it’s covered or not! If you’re looking for another product – reach out to a distributor who sells that product – they do the same insurance verification process.

 


I hope this helps you all – and if you have more insurance questions be sure to let us know and we’ll include them in our next installment of the Understanding Your Insurance series.

Get Help Now! 

Topics: Medicare, how to, insurance

Open Enrollment: What You Need to Know About Medicare Advantage

Posted by Mens Liberty

Oct 23, 2015 11:00:00 AM


I just spend two and half hours on the phone with 1-800-Medicare. It was NOT fun. A friend signed up for a Medicare Advantage plan last year and it’s turned into an epic, if predictable, disaster. I was trying to help clean up the mess.

So why am I telling you? As our regular readers know, we are committed to sharing the best information that we can with all of you. Open enrollment is going on from October 15th to December 15th so now is the perfect time to be talking about the kind of insurance choices you should be making for the year ahead.


One of the biggest choices you will make is whether or not to sign up for a Medicare Advantage plan. For those of you new to the game, a Medicare Advantage plan is a private insurance replacement for Medicare Part A, i.e. hospital coverage, and Medicare Part B, also known as out-patient coverage. The private insurance company takes over your coverage and promises to cover everything that traditional Medicare would cover and lower your out of pocket costs.

Sounds too good to be true… and well for 98% of us, it is.

You see a Medicare Advantage plan works like any other HMO – you have to use in network physicians and get referrals for everything. They also may require you to use lower cost options or deny access to certain high cost medications.

So what happened to that friend of mine –two years ago, she started losing the feeling in her right arm. She went to a chiropractor and treatments were helping. Everything was covered under her traditional Medicare plan. Then she signed up for the AARP United Medicare Complete HMO plan. When the same problem came back this year she discovered the dark side of Medicare Advantage.

Although United claimed to provide coverage for chiropractic services, there were ZERO doctors in her area that accepted her insurance – no one within 50 miles!! Can you believe it! And because she had an HMO the insurance wouldn’t pay for any out of network coverage.

So now she is paying thousands of dollars for medical treatment that is supposed to be covered. That’s why I spent so much time on the phone – I was racking my brain trying to figure out how this was even legal, and then after much research I understood.

An Advantage Plan is required to cover everything that traditional Medicare covers but there are no rules that govern how much they have to pay doctors. So if Medicare would normally pay $10, the Advantage Plan can say they will only pay $4 for the same service. Doctors that can’t afford to provide that service for $4 opt out of accepting the insurance plan.  

That’s exactly what happened to that friend of mine. The AARP United Medicare Advantage Plan was offering chiropractors so little money that they had to opt out of accepting that insurance plan. Doctor’s offices are businesses too and they need to at least break even.

The stunning thing here – all of this is completely legal; possibly unethical, bad business, bad for patients and completely legal.

Now, I don’t want you to think that all advantage plans are terrible. For patients who are in excellent health and do not have any chronic conditions, they can be a good choice. Think of it like a bet. You are betting on whether or not you will need more or less coverage than the policy provides. The insurance company bets you will need less – that’s how they make money. If they’re right you both save some money. If they’re wrong, you’re the one footing the bill, not the insurance company.

So now that open enrollment is right around the corner, take a long hard look at your options for healthcare coverage for 2016. You have three choices:

  • Traditional Medicare
  • Traditional Medicare & a Medi-Gap plan or
  • Medicare Advantage

My only caution is this – Before choosing any Advantage plan be sure to read all the exclusions in your contract. Don’t be blinded by advertisements offering $0 co-pays. If it sounds too good to be true – it probably is!

We’ll be taking a detailed look at Medi-Gap plans in another bonus edition of Understanding Your Insurance. Until then - let us know if we've missed anything or share your insurance horror stories in the comments below.  

Regain Your Freedom Today!


 

Topics: proactive patients, Medicare, insurance, incontinence