Indiana Medicaid Provider Update: Incontinence Product Authorization Changes

To meet state requirements, effective January 1, 2026, prior authorization will be required for most incontinence products when the services provided exceed the monthly monetary benefit limit for UnitedHealthcare Community Plan of Indiana members. This update applies to both Indiana PathWays for Aging and Hoosier Care Connect.

This policy impacts most incontinence items. However, certain incontinence product service codes (see Table 10) are eligible for coverage above the monthly limit.

Prior Authorization Guidelines

• Requests for benefits beyond the monthly limit will be approved based on medical necessity. Please include the following with your submission:
• Nursing assessment: Members must complete a nursing assessment to confirm the appropriate product type, brand, and quantity. The assessment must be completed by a licensed nurse employed by the supplying provider.
• Clinical records supporting the need for additional supplies
• The exact monthly quantity needed, along with any factors affecting the frequency and duration of use

How to submit New or Updated Requests 

Fax the completed universal provider authorization fax form along with all supporting medical-necessity documentation.