To get PureWick covered by insurance, you need a prescription that documents medical necessity, the correct HCPCS billing codes on the claim (E2001 for the pump and A6590 for the disposable wicks), and, whenever possible, a purchase routed through a Medicare-enrolled or in-network durable medical equipment supplier that can bill your insurer directly. Coverage still varies by plan, and denials are common, so knowing the appeal path matters as much as the initial paperwork.
Start With a Prescription That Documents Medical Necessity
Every coverage path begins with the same document: a prescription from a Medicare-enrolled or in-network provider that shows the PureWick is genuinely needed, not merely preferred. Generic template letters get flagged and denied more often than personalized ones tied to the patient’s actual medical history.
Ask your prescriber to include four things:
- A specific ICD-10 diagnosis code, such as N3941 (urge incontinence), N39490 (overflow incontinence), N3946 (mixed incontinence), or R32 (unspecified urinary incontinence).1Centers for Medicare and Medicaid Services. ICD-10-CM/PCS MS-DRGv33 Definitions Manual – Kidney and Urinary Tract Signs and Symptoms
- The severity and daily impact of the condition, including effects on sleep, skin integrity, and infection risk.
- Documentation that cheaper alternatives — absorbent pads, condom catheters, or similar methods — were tried and proved inadequate or caused complications.
- The expected benefit, such as preventing skin breakdown or recurrent urinary tract infections.
A separate letter of medical necessity, written in narrative form, strengthens the case considerably. Some insurers also require a trial period with alternatives before they’ll approve coverage, and many mandate re-evaluations every six to twelve months. Missing a re-evaluation deadline can end coverage even when nothing has changed medically.
Use the Right Billing Codes
An incorrect code is one of the most common reasons PureWick claims get denied, and it’s also one of the easiest problems to prevent. As of 2024, the applicable HCPCS codes are:2CGS Administrators, LLC. PureWick Urine Collection System – Coding and Billing Instructions – Revised
- E2001 — the suction pump (home model, portable or stationary, electric, for use with an external urine or fecal management system)
- A6590 — the disposable wicking catheter, per month
- A7001 — non-disposable canister used with the pump
- A7002 — tubing used with the pump
The older temporary code K1006 covered the pump through December 31, 2023. If you see K1006 on any paperwork dated 2024 or later, get it corrected before the claim goes in. Claims filed under expired codes get rejected automatically.
Buy Through a Supplier That Can Bill Your Insurer
Orders placed through the PureWick at Home website are cash sales only. BD will not submit claims or collect reimbursement on your behalf for those purchases.3BD PureWick. All Products – First-Time Orders Buying that way means paying up front and then filing your own reimbursement claim after the fact.
The simpler route is a durable medical equipment supplier that carries PureWick-compatible products and bills your insurance directly. Ask your insurer for a list of in-network DME suppliers, then confirm with the supplier that they can handle prior authorization and claims submission before you place an order. For Medicare, the supplier must be Medicare-enrolled.
What Medicare Covers
Original Medicare does not cover incontinence supplies like adult diapers or absorbent pads.4Medicare.gov. Incontinence Supplies and Adult Diapers The PureWick is classified differently: it’s an external catheter with a suction pump, which falls under durable medical equipment. As of January 1, 2024, CMS assigned HCPCS code E2001 to the pump and A6590 to the disposable wicks, and coverage for urological supplies is governed by Local Coverage Determination L33803.5Centers for Medicare and Medicaid Services. Urological Supplies
To qualify:
- A Medicare-enrolled clinician must prescribe the device for home use.
- Medicare will generally not approve coverage if the patient also has an indwelling catheter in place.
- For the female version, Medicare limits use to no more than one metal cup or pouch per week.
- The device must be obtained through a Medicare-enrolled DME supplier, not the manufacturer’s website.
Medicare Advantage plans must provide at least the same benefits as Original Medicare, so if Original Medicare covers the PureWick under DME, Medicare Advantage plans must as well. They set their own cost sharing, preferred supplier networks, and prior authorization rules, though. Call the number on your plan card and ask specifically about codes E2001 and A6590 before ordering. Medigap policies can pick up the 20% Part B coinsurance on approved DME claims, but Medigap does not independently cover anything Medicare denies.
Veterans enrolled in VA healthcare may be able to obtain external catheters through the VA formulary at a zero copay tier. The formulary does not reference the PureWick brand by name, so availability depends on what your VA medical center stocks. Contact your primary care provider or prosthetics department to ask about external catheter options.
Private Insurance and Medicaid
Private insurers generally classify the PureWick as DME, but classification alone doesn’t guarantee coverage. Some policies exclude incontinence-related supplies or treat external catheters as convenience items rather than medically necessary equipment. Employer-sponsored and higher-tier individual plans tend to be more flexible than bare-bones marketplace plans.
Before you buy, call your insurer and ask three specific questions:
- Does the plan cover DME generally?
- Does it cover external urinary catheter systems under HCPCS codes E2001 and A6590?
- Is prior authorization required?
Some plans cover rentals but not purchases. Others reimburse only through in-network DME suppliers, or cap annual DME spending at a fixed dollar amount. Getting these answers in advance prevents expensive surprises.
One boundary worth naming: at least one major insurer, Kaiser Permanente, has explicitly classified the PureWick system as a non-covered item for home or long-term care use under its medical coverage policy.6Kaiser Permanente. Purewick Urinary Collection System Medical Coverage Policy If your plan has a similar blanket exclusion, your path runs through appeals or alternative payment methods rather than standard claims.
Medicaid coverage varies by state. Roughly 45 states cover some form of incontinence supplies, but eligibility criteria and amounts differ dramatically. Most state programs require a physician’s prescription, a qualifying diagnosis, and often prior authorization or a letter of medical necessity. Contact your state Medicaid office or managed care plan to confirm whether the PureWick specifically falls within covered supplies.
Filing Your Own Reimbursement Claim
If you paid out of pocket and want reimbursement, you file the claim yourself. Most insurers require a completed claim form (from the member portal or member services), an itemized receipt showing the HCPCS codes and purchase price, and a copy of the prescription.
Deadlines matter. Many private insurers require claims within 90 days of purchase.7NAIC. Health Care Bills – Filing Health Insurance Claims Medicare allows up to 12 months from the date of service.8CGS Medicare. Timely Claim Filing Requirements Don’t wait until the last week. Filing early leaves room for the insurer to request additional documentation without pushing past the deadline.
Submit through whatever channel the insurer prefers — portal, fax, or mail — and keep copies of everything. If mailing, use certified mail with a return receipt. Most states require insurers to acknowledge receipt within about 15 days and issue a decision within 30 to 45 days. If your claim has been sitting for more than six weeks with no response, call member services and reference your confirmation number.
If the Claim Is Denied
Denials are common with the PureWick, especially from insurers that still treat it as a convenience item. Insurers must explain the denial in writing, and that explanation tells you what to address. The usual reasons are lack of medical necessity documentation, missing or incorrect billing codes, or a blanket policy exclusion. Each calls for a different response.
Internal Appeal
You have 180 days from the date of the denial notice to file an internal appeal.9HealthCare.gov. Appealing a Health Plan Decision – Internal Appeals Include a written letter explaining why the denial was wrong, plus any evidence you didn’t submit originally: an updated letter of medical necessity, progress notes documenting failed alternatives, or clinical literature on the device’s effectiveness for your condition. If the denial cited a coding error, resubmit with corrected codes and a note explaining the correction. Your state’s Consumer Assistance Program can help you prepare the appeal at no cost.
External Review
If the internal appeal fails, federal law gives you the right to an external review by an independent reviewer outside the insurance company. The insurer is legally required to accept the external reviewer’s decision.10HealthCare.gov. External Review
You must request external review in writing within four months of receiving the internal appeal denial. Standard reviews are decided within 45 days. When there’s medical urgency — active skin breakdown or recurring infections, for example — an expedited review can be decided within 72 hours. External review is available for any denial involving medical judgment, including determinations that a device is not medically necessary or is experimental.
This is where strong clinical documentation pays off. The independent reviewer looks at the medical evidence rather than the insurer’s internal policy, so a detailed physician letter and clear proof of failed alternatives carry real weight.
Cutting Costs When Coverage Is Partial or Denied
Replacement wicks need to be changed daily and run about $209 for a box of 30, which comes to roughly $2,500 a year in wicks alone. Even with partial coverage, a few options lower what you actually pay.
Health savings accounts and flexible spending accounts allow tax-free reimbursement for qualified medical expenses, which the IRS defines broadly enough to include prescribed medical devices and supplies.11Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans Keep the prescription and itemized receipts in case your plan administrator asks. Because contributions are pre-tax, this effectively reduces the cost by your marginal tax rate; for someone in the 22% bracket, that’s about $550 in annual tax savings on $2,500 of supplies.
BD’s AutoShip subscription program takes 5% to 10% off wick refills depending on order size, with free shipping on orders over $100, and the company has posted a 10% discount on starter sets with battery through at least May 2026.12BD PureWick. Discounts – PureWick The savings per order are modest, but on a daily-use product they add up over the course of a year.