Frequently Asked Questions (FAQs)
Check our Frequently Asked Questions (FAQs), about eligibility, durable medical equipment and Incontinence supplies. If you don’t find what your questions fill out the contact form (here) we’ll answer you promptly or call in office hours 9am – 5pm EST MON thru FRI, TOLL FREE number 1 888 504 49 56. Or office number +1 305 887 24 60 or fax us: 305 220 43 74, email: sunshinemedicaldme@gmail.com.
What kind of medical products do you provide?
We provide: Incontinence, Wound Care, Urological, Ostomy, Nutritional products as well as Durable Medical equipment (wheelchairs, Hospital Beds etc.) Feel free to check our product catalog here
What are the office hours?
9am – 5pm EST MON- FRI. Phones transferred after hours
What is Medicare?
Medicare is the federal health insurance program for: people who are 65 or older (who have paid into Medicare during their lives). Certain younger people with disabilities, people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
The different parts of Medicare help cover specific service Call at 1-800-MEDICARE (1-800-633-4227).
Medicare Part B (Medical Insurance), part B covers certain doctors’ services, outpatient care, MEDICAL SUPPLIES, and preventive services.
Does Medicare cover incontinence supplies?
Medicare does not cover incontinence pads or adult diapers. You pay 100% for incontinence pads and adult diapers. Although Some Medicare Advantage Plans (Part C) offer extra benefits that Original Medicare doesn’t cover, like: vision, hearing, or dental.
What is Medicaid?
Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program (CHIP), provides health coverage to: children, pregnant women, parents, seniors, and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States. It is based on financial need.
Does Medicaid covers incontinence supplies?
The answer is yes and no. Programs and benefits vary by state, but most states’ Medicaid programs DO cover incontinence supplies. We will help you navigate your Medicaid program.
People with certain long-term disabilities also qualify for Medicare
If you have Medicaid, most likely your plan will cover at least some of the cost of your adult diapers.
Can someone be eligible for both Medicare and Medicaid?
Yes, beneficiaries who are eligible for this combination of coverage are sometimes called Medicare dual eligible.
If you are dual eligible for Medicare and Medicaid, you may qualify for a special type of Medicare Advantage (Part C) plan called a Medicare Dual-Eligible Special Needs Plan (D-SNP).
What a are the differences between Medicaid and Medicare?
Two of the key differences between Medicare vs. Medicaid include:
Medicare is for people age 65 and over and for certain people under 65 who have a qualifying disability. Medicare eligibility is consistent for everyone across the U.S., no matter what state you live in.
Medicaid is for people of any age who meet certain income qualifications. Medicaid is administered by state governments, and eligibility requirements can differ between states.
Who can be dual eligible for Medicare and Medicaid?
To be Medicare dual eligible, you have to meet the requirements for Medicare and your state’s Medicaid program.
To be eligible for Medicare, you must:
- Be at least 65 years old or having a qualifying disability
- Be a U.S. citizen or permanent legal resident
- Be eligible for benefits through Social Security or the Railroad Retirement Board
Generally speaking, Medicaid provides health insurance to low-income individuals and families, children and pregnant women. The best way to find out if you are eligible for Medicaid is to visit your state’s Medicaid website.
What is CHIP?
CHIP is a Medicaid program for children and stands for Children’s Health Insurance Program.
CHIP benefits vary by state, but they generally include EPSDT, or Early and Periodic Screening, Diagnostic and Treatment services. This coverage is designed to ensure children receive proper early detection and related care so that health problems may be averted or diagnosed as early as possible.
CHIP programs in all states must provide well-baby and well-child care, dental coverage, behavioral health care and vaccines.
CHIP serves uninsured children up to age 19 in families that earn too much money to qualify for Medicaid but still have trouble affording care.
What kind of incontinence supplies can I get from Sunshine Medical?
We offer a wide range of Incontinence products: Unisex and Gender specific male and female: Adult briefs (diapers), Protective underwear (Pull-ups), Underpads (chuxs) and bladder control pads (Liners, pads & guards), from light to maximum absorbency. Not all products are available to Medicaid plans due to different allowances from state to state.
How do I know which size I need?
We’ve provided sizing guidelines on all of our product and resource pages to help narrow down your specific sizing needs. Since no two bodies are alike, these should only be viewed as a guide, For extra help for your specific sizing needs, call us! We’re here to help you through the product selection process.
What's your largest size adult diaper available?
We have a variety of products for those with bariatric sized needs.
Do you have a shorter extra small products or youth-sized products?
We have several extra small, youth-sized products that have also worked well for smaller adults. Our care experts can provide additional information and provide samples. Please call toll free +1 888 504 4956 or email us at Sunshinemedicaldme@gmail.com, we’ll be happy to bring support.
Do you have incontinence products for men?
Yes, feel free to check our catalog incontinence/men category it will display the best options for you, which includes, bladder control pads, adult diapers etc.
If I am in a hospital, nursing home, hospice or other skilled nursing facility, can I get incontinence supplies from Sunshine Medical Supplies?
No. Sunshine Medical can only deliver supplies to your home. We are not able to supply incontinence supplies to individuals residing in a skilled nursing facility.
Does Sunshine Medical only provide incontinence supplies?
Besides incontinence products, Sunshine Medical Supplies also offers urology supplies and catheters, pediatric supplies, ostomy supplies, wound care, and nutritional drinks. As well as, durable medical equipment.
Do you have a store or are you online only?
Our office and warehouse are located in Miami, Florida. We do have a retail store; local customers are welcome to pick orders up during business hours, Monday through Friday. For customers who prefer to order online and wish to pick up their order, please let the customer service representative know and we’ll have your order ready in less than 30 minutes.
Do you have a catalog?
We do not have printed catalogs available at this time; however, every product that we sell is available to view ONLINE with detailed information. For any additional information or questions, please call us at +1 888 504 4956
Are you involved in third party billing?
Yes, we have a team of experienced billing specialists representatives involved in third party billing.
Do you provide reimbursement codes (HCPCS Codes)?
We use the Healthcare Common Procedure Coding System (HCPCS) code suggestions based on official guidelines as a convenience to our customers. We do make claims we submit to our contracted health plans, which guarantees most of the time [previously checking patient eligibility and paperwork organized] the availability of reimbursement for Sunshine Medical.
We determine the appropriate billing code for a product, as well as, whether the use of a product complies with medical necessity and other documentation requirements of the payor.
Do I need a prescription from my doctor to get incontinence supplies from Sunshine Medical?
Yes, in order for a Medicaid plan to cover incontinence supplies, they must be considered “medically necessary”. And your physician must provide a prescription to Sunshine Medical. Each Medicaid program has different requirements about which incontinence products are considered medically necessary, so the supplies covered will vary from state to state.
Once we determine that you are eligible to receive incontinence supplies from Sunshine Medical, our Customer Representatives will contact your doctor for a prescription and any required medical information. There are reasons for this step in the process that may take a while:
- Doctors are busy professionals and it sometimes takes a while for them to answer our request for paperwork.
- If you’ve not been to your doctor in a while, he or she may need to see you before they will provide Sunshine Medical with a prescription.
- An error may require the paperwork to be redone. Insurance plans have strict guidelines for completing paperwork and if it is not completed properly, we may have to go back to your doctor for a correction.
It is advisable that you let your doctor know you’re working with Sunshine Medical to receive supplies through Medicaid. (call us so we can assist you further)
Why can’t I get incontinence supplies paid for by Florida Medicaid?
Florida Medicaid does not cover adult incontinence supplies. However, Florida Medicaid does cover incontinence supplies for pediatric patients who are age 4 to 20.
Do you have free shipping?
Enjoy free shipping on all orders in the USA. Discreetly delivered each month.