Home Delivery of Incontinence Supplies for Eligible Medicaid Recipients

If you or someone you care for has Medicaid benefits and is in need of medical supplies, let HDIS help! Call or complete the form to see if you or someone you care for qualifies for a Free Sample with their first Medicaid Order.

Follow these easy steps to find out if you are eligible:

Check the listing of states below to see if services are offered in your state.
Fill out the form on this page.
We will contact you to let you know your options!

What HDIS does for you!

We will take care of every detail! HDIS will contact your doctors for all of the paperwork and take care of your billing.
No Hassle Renewals! HDIS will call and confirm an order is needed before you run out.
Discreet Shipping direct to your front door.
Personalized Product Consultation from our Trusted Advisors.
Product Samples are available to make sure you get the correct fit!

View Medicaid Fee Schedules

HDIS Medicaid Assignment of Benefits (AOB) View AOB PDF

Qualify for a Free Sample

Please complete this form. HDIS will call you to get started! For faster service, give us a call at
1-855-258-1138

First Name *

Last Name *

Phone Number *

Email Address *

Street Address *

Street Address 2

City *

State *

ZIP Code *

Product User's Birthdate

If the products are for your child, please use their birthdate. Note: MedicaidTv does not cover baby diapers under age 3 or 4.

Product User's Medicaid Card Number

Thank you!

By submitting your information you consent to be contacted by HDIS. HDIS will use the information you provide to check your eligibility with your state's MedicaidTv program. Your personal information will never be sold or shared.

*if qualified, samples will be included with first Medicaid order

Medicaid Fee Schedule by State

Below are links to Medicaid Provider Fee Schedules for covered services provided to eligible Medicaid recipients. The information is published and maintained by your State's Medicaid program . Fee Schedules are subject to change frequently with or without notice . Please check your State's website for the most recently published information.

State	Fee Schedule	Website
Arkansas	View	Visit
Colorado	View	Visit
Florida	View	Visit
Iowa	View	Visit
Idaho	View	Visit
Illinois	View	Visit
Louisiana	View	Visit
Maryland	View	Visit
Minnesota	View	Visit
Missouri	View	Visit
New Jersey	View	Visit
New York	View	Visit
Ohio	View	Visit
Texas	View	Visit
Washington	View	Visit
CMS/Medicare DMEPOS Price List	View	Visit