Question: Does anyone's insurance cover anything to catch the mucous from your k pouch stoma? I use nursing pads now but would like to use something like an AM patch. But they are kind of pricey. I know different insurances are different and also different docs are more skilled at knowing what to prescribe for monthly medical supplies. With my conventional ostomy (both different doc and insurance than I have now) I got all my bags/flanges covered PLUS a variety of stoma creams, pastes, wipes, powders. But now I only get catheters and lube (And that I had to fight for!) I miss being able to order the anti fungal powder and of course something to catch the mucous. Just wondering..... Thanks in advance.
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i couldn't get edgepark to understand that i wanted an absorbent spongy type of material so i am using nursing pads and sanitary pads.
what is an AM patch?
good to hear you can get 9 tubes of lub. i'll keep pushing them for my 6. interesting that you need that many. how often a day do you intubate? janet
Hi Rosie-
Where do you get your supplies? My insurance covers all my supplies but I pay a small co-insurance. I understand with Edgepark (in which Cleveland Clinic uses), you need a prescription from the stoma nurse for most everything. Additionally, the supply company must have the proper diagnosis or they deny the claim. That can be a call from you or a nurse (especially since K-Pouch/BCIR are not common). Maybe that will help? As far as AM patches, if you have a lot of mucus, they don't work well at all (I have found). The Allevyn pads absorb mucus and pull it away from the skin. The pads come in different sizes too. But they are expensive, that is why I also use the nursing pads periodically. As far as what works best for you, the stoma nurse is your best bet...they know what will work based on your current situation or issue. Otherwise I contact a rep at Edgepark and ask if they can help. For CCF, I contact Megan Naismith. I know this is incredibly frustrating...I am there too. But it sounds like you have a plan, it is just waiting for it all to come together. Hang in there! Kara
Thanks for the responses! AM is the brand I think. You can google it to see their website. I have quite a bit of mucous. I change a nursing pad with every intubation. I hate keeping them in place though. Right now I wear a Bella Band that I got when pregnant to hold pad in place. It works well because I have extra skin sagging around my tummy. If I don't wear the Bella Band the pad shifts and I soak my clothes. I like the idea of the AM patch sticking like a bandaid, and not fussing with tape to hold in place. Hmmmm. I will have to do some more thinking. Also hoping that I get better insurance in the fall and will be able to have Dr. Rehnke in St. Pete write me a script for the necessary supplies.
Thanks!
Hi Rosie, I think the company you are talking about is AMPatch. I use them and my insurance and Medicare pays except for the co-pay. Their Phone is #800-223-9310. I found them very helpful and they will send sample packets, they have catheters, syringes, etc. I very much like the stoma covers unless I am really, really, having a problem. Give them a try if you want & get some samples. Good Luck. JudithS.
Hi Rosie. Ampatches are made by Austin Medical in New Hampshire. They are very helpful in recommending the most suitable patch and will send you free samples. Austin will bill Medicare for you, but you must pay them the full cost at the time of your order and then Medicare will reimburse its share directly to you. If you want Medicare to pay the supplier directly, you will need to order from a Medicare authorized supplier like Edgepark or Byram. In order for your Medicare supplement to pay its part, you would need to use one of their in-network suppliers.
I actually buy U by Kotex Security Ultra Thin Pads, Regular, Unscented, 44 Count.
I cut them in half. They adhere to my underwear and cover the stoma. I have used these for years after trying others that weren't as gentle on my stoma site.
As a male, I used to get some funny looks buying multiple packs at the grocery store...but Amazon has pretty much solved that difficulty!!