Urological Supplies

Aetna covers urinary catheters and external urinary collection devices as medically necessary prosthetics for members with permanent urinary incontinence or permanent urinary retention (not expected to be corrected within 3 months), including TuckSpecialty and all-silicone indwelling catheters when a straight Foley cannot be used. Routine indwelling supply limits are one catheter per month with quantities of drainage supplies per the policy table; additional or non‑routine changes and extra components are allowed only for exceptional circumstances (e.g., accidental removal, obstruction, malfunction, recurrent obstruction/UTI), catheter insertion trays aren’t indicated for clean intermittent catheterization, and either a vinyl or a latex leg bag is allowed (not both) while leg bags for bedridden members are not considered medically necessary.

"Medically necessary supplies for medically necessary continuous bladder irrigation include a 3-way Foley catheter, irrigation tubing set, and sterile saline or sterile water."