Understanding Catheter Coverage

Navigating the world of catheter coverage can be confusing and overwhelming, but you don't have to do it alone. Wheter you're looking for details on insurance policies, understanding your benefits, or finding the right supplies, we're here to guide you every step of the way.

What steps do I need to take to get my products and insurance in place?

Determine that there is a medical need for the product!

Speak to your healthcare provider if you feel you need assistance emptying your bladder.
The recommendation to start intermittent catheterization should come from a Urologist or Health Care Provider.

Product Trial

Your Urologist or Health Care Provider can recommend a product for you to trial
Sign up for Coloplast Care to access additional product samples (ie: compact options for travel)
Decide which catheter(s) work best for you and your lifestyle

Prescription / Letter of Recommendation

Product(s) has/have been decided on
Doctor/Urologist has recommended a usage frequency (ie: catheterize 4 times per day)
Doctor/Urologist provides a prescription* and fills out the Coloplast Letter of Recommendation

Submit documents to insurance provider

Prescription* / Coloplast Letter of Recommendation completed by healthcare provider
Quote from retailer (facilitated by Coloplast Care team) OR
Initial receipt (for those purchasing prior to submitting claim)
Any claim forms required by your insurance provider
Contact the Coloplast Care team if you need additional support

* Prescription is not required to purchase intermittent catheters in Canada, but some insurance providers will request one as documentation to support a claim.

What to do if my insurance company denies my medical supplies claim?

"Often, success is found with persistence in submitting, resubmitting if required, and providing the correct documentation.” -- Gallian, Senior Bilingual Consumer Support Representative - DTC Read more

1. Follow up with your insurance provider

Request a detailed explanation as to why the claim was denied. The insurance company should be able to justify why the items requested are not covered.

2. Consider notes or fine print

Can you provide further information or clarification in order for your provider to find the appropriate area of coverage?

3. Collect additional documentation as required

Coloplast Letter of Recommendation: Outlining the medical need for your products prescription* from your healthcare provider detailing product usage frequency. Quote from retailer: Including product codes and pricing, based on frequency outlined by your prescription. Coloplast Care Team: can help you with obtaining a quote, product-related documents, and provide you with the Letter of Recommendation. Feel free to reach out to Coloplast Care if you have any questions related to your product of choice.

4. Resubmit your claim

Submit your claim with additional details & documentation.

Resources you may find helpful

Download our guide to find answers to FAQs

You may have additional questions about costs, coverage plans, and more. Download out guide to find answers to the most frequently asked questions about private insurance. View FAQs

Fill out your Letter of Recommendation

Filling out your Coloplast Letter of Recommendation can provide additional support for your claim, by giving providers a rationale as to why you need a specific catheter. Download now

Still have questions or concerns about coverage?

Our Coloplast Care Team can help you find a retailer that meets your specific needs, as well as facilitate a quote to provide to your insurance provider. Contact the Coloplast Care team for questions about your insurance coverage at casupport@coloplast.com or call us at 1-866-293-6349.

Coloplast provides this information for convenience and your general reference only. It does not constitute legal advice or a recommendation regarding clinical practice. Reimbursement, coverage and payment policies can vary from one insurer and region to another and is subject to change without notice. The provider has the responsibility to determine medical necessity and to submit appropriate codes, information, and charges for care provided. Coloplast does not guarantee coverage or payment of products and Coloplast makes no guarantee that the use of this information will prevent differences of opinion or disputes with providers, agencies, insurers, or other payors as to the correct form of billing or the amount that will be paid. This information is provided for your general information only and is not intended to replace any advice you receive from your own internal or external insurance coverage consultants, reimbursement specialists or legal counsel.

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