Many parents ask whether their child qualifies for diapers or pull-ups. While every state’s Medicaid program has its own guidelines, the type of product your child receives is generally based on medical necessity, your child’s abilities, and your healthcare provider’s documentation.
Diapers
Diapers are typically recommended for children who:
- Are not independently toileting.
- Require caregiver assistance for changing.
- Need maximum absorbency for daytime or overnight use.
- Have limited mobility or developmental delays that make pull-ups inappropriate.
Pull-Ups
Pull-ups may be appropriate for children who:
- Are toilet training or can participate in changing themselves.
- Can pull the garment up and down with little or no assistance.
- Need protection while working toward greater independence.
- Have a healthcare provider who documents that pull-ups are medically appropriate.
Can I Choose Either One?
Not always. Medicaid reviews the medical documentation provided by your child’s healthcare provider. If the requested product does not meet your state’s medical necessity guidelines, coverage may be denied, or a different product may be approved.
If your child’s needs change over time, let us know. We can work with your healthcare provider to determine whether updated documentation is needed to request a different product. Review our Product and Size Guide for more information on what products we typically provide.
Need help? Our team is happy to answer questions about covered products and guide you through the approval process.