Patient Assistance Program Ostomy Care

For years, ConvaTec has been committed to helping people with an ostomy overcome the many challenges they face - including affording ostomy supplies. Through the ConvaTec Ostomy Access Program®, we provide ostomy supplies to financially eligible patients on a temporary basis, at no charge.*Patients who are uninsured and are unable to afford the cost of the Ostomy supplies may be eligible. While ConvaTec will make every effort to grant aid when needed, the program is limited by available resources and may be discontinued or changed at any time. This program is offered in the United States only (50 states and the District of Columbia).

To receive general information and a list of products covered by the program, please call the ConvaTec's Customer Interaction Center at 1-800-422-8811.

*Any product received is for own-use, is not for resale, and cannot be billed to any insurance company, patient or third-party payor, including but not limited to Medicare and Medicaid. Program is subject to change without notice. Other restrictions may apply.

Qualification Guidelines

To receive a three-month supply of ostomy products one time every 12 months through the ConvaTec Ostomy Access Program®, patients must certify all of the following:

  • Patient may not have any prescription assistance through third-party coverage such as Medicaid, Medicare, Private Insurance or Health Maintenance Organization (HMO).
  • Patient must state that they are not able to purchase their ConvaTec Ostomy supplies.

Product Offering

Click to download PDF Product Offering


Order #

ONE-PIECE OSTOMY APPLIANCES

064927

ActiveLife® One-Piece Urostomy Pouch with Stomahesive® Cut To Fit

400599

ActiveLife® One-Piece Drainable Pouch With Durahesive Plus®
Skin Barrier, 12" Opaque

022771

ActiveLife® One-Piece Drainable Custom Pouch with Stomahesive®
Skin Barrier, 12" Trans

   

Order #

TWO-PIECE SKIN BARRIERS WITH CONVEXITY

413188

SUR-FIT Natura® Durahesive®Wafer w/CONVEX-IT® 2"

413187

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 1 3/4"

413186

SUR-FIT Natura® Durahesive®Wafer w/CONVEX-IT® 1 5/8"

413185

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 1 1/2"

413184

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 1 3/8"

413183

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 1 1/4"

413182

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 1 1/8"

413181

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 1"

413180

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 7/8"

413179

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 3/4"

413178

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 5/8"

413177

SUR-FIT Natura® Durahesive® Wafer w/CONVEX-IT® 1/2"

404592

SUR-FIT Natura® Durahesive® Moldable Convex Skin Barrier w/45 mm-1 ¾",
Flange-Sm ½"-7/8"

404593

SUR-FIT Natura® Durahesive® Moldable Convex Skin Barrier w/45 mm-1 ¾",
Flange-Med 7/8"-1 1/4"

404594

SUR-FIT Natura® Durahesive® Moldable Convex Skin Barrier w/45 mm-1 ¾",
Flange-Lrg 1 1/4"-1 3/4"

   

Order #

TWO-PIECE SKIN BARRIERS

125261

SUR-FIT Natura® Stomahesive® Flexible 5" x 5" Wafer WHT 2 3/4"

125260

SUR-FIT Natura® Stomahesive® Flexible 5" x 5" Wafer WHT 2 1/4"

125259

SUR-FIT Natura® Stomahesive® Flexible 4" x 4" Wafer WHT 1 3/4"

125258

SUR-FIT Natura® Stomahesive® Flexible 4" x 4" Wafer WHT 1 1/2"

125257

SUR-FIT Natura® Stomahesive® Flexible 4" x 4" Wafer WHT 1 1/4"

411801

SUR-FIT Natura® Stomahesive® Moldable Skin Barrier 1 3/4",
Flange Opening Small

411803

SUR-FIT Natura® Stomahesive® Moldable Skin Barrier 1 3/4",
Flange Opening Medium

411805

SUR-FIT Natura® Stomahesive® Moldable Skin Barrier 2 1/4",
Flange Opening Large

411807

SUR-FIT Natura® Stomahesive® Moldable Skin Barrier 2 3/4",
Flange Opening Extra Large

   

Order #

TWO-PIECE SKIN BARRIERS

413163

SUR-FIT Natura® Durahesive® Flexible Wafer, 5" X 5" WHT 2 3/4"

413162

SUR-FIT Natura® Durahesive® Flexible Wafer, 5" X 5" WHT 2 1/4"

413161

SUR-FIT Natura® Durahesive® Flexible Wafer, 4" X 4" WHT 1 3/4"

413160

SUR-FIT Natura® Durahesive® Flexible Wafer, 4" X 4" WHT 1 1/2"

413159

SUR-FIT Natura® Durahesive® Flexible Wafer, 4" X 4" WHT 1 1/4"

411800

SUR-FIT Natura® Durahesive® Moldable Skin Barrier 1 3/4",
Flange Opening Small

411802

SUR-FIT Natura® Durahesive® Moldable Skin Barrier 1 3/4",
Flange Opening Medium

411804

SUR-FIT Natura® Durahesive® Moldable Skin Barrier 2 1/4",
Flange Opening Large

411806

SUR-FIT Natura® Durahesive® Moldable Skin Barrier 2 3/4",
Flange Opening Extra Large

   

Order #

TWO-PIECE DRAINABLE POUCHES

401504

SUR-FIT Natura® Drainable Pouch, 12" Opaque, 2 3/4"

401503

SUR-FIT Natura® Drainable Pouch, 12" Opaque, 2 1/4"

401502

SUR-FIT Natura® Drainable Pouch, 12" Opaque, 1 3/4"

401501

SUR-FIT Natura® Drainable Pouch, 12" Opaque, 1 1/2"

401500

SUR-FIT Natura® Drainable Pouch, 12" Opaque, 1 1/4"

   

Order #

TWO-PIECE UROSTOMY POUCHES

401546

SUR-FIT Natura® Urostomy Pouch with Accuseal® Tap, Trans. Standard, 2 3/4"

401545

SUR-FIT Natura® Urostomy Pouch with Accuseal® Tap, Trans. Standard, 2 1/4"

401544

SUR-FIT Natura® Urostomy Pouch with Accuseal® Tap, Trans. Standard, 1 3/4"

401543

SUR-FIT Natura® Urostomy Pouch with Accuseal® Tap, Trans. Standard, 1 1/2"

401542

SUR-FIT Natura® Urostomy Pouch with Accuseal® Tap, Trans. Standard, 1 1/4"

   

Order #

ACCESSORIES

027060

Night Drainage Set (limit 1 per every 6 months)

183910

Stomahesive® Paste, 2 oz. tube (limit 3 per order)

037436

AllKare® Adhesive Remover Wipe - 50 Pack (limit 1 per order)

037439

AllKare® Protective Barrier Wipe - 50 Pack (limit 1 per order)

025542

Stomahesive® Strips (Moldable Adhesive)

025510

Stomahesive® Protective Powder, 1 oz. (limit 1 per order)

175507

Ostomy Appliance Belt (limit 1 per every 6 months)

Links to Ostomy Supply Resources

Suppliers that specialize in patients with no insurance

FREQUENTLY ASKED QUESTIONS

How long does it take to receive ostomy supplies?

If approved for the program, the patient receives product within approximately 14 business days from the day the call is placed from the patient to the ConvaTec's Customer Interaction Center

Once approved, how long will I be eligible to participate in the program?

Patients are eligible to receive their ostomy supplies for a period of three months once a year. Patients will be eligible to receive a second shipment twelve months later from their last shipment of free product.

How much supply will I receive at a time through the program?

At any one time, the Ostomy Access Program® will provide a 3-month supply of ostomy supplies, once every twelve months.

How will I know when I need to re-apply?

Patients should re-apply one month before their ostomy supplies run out by calling ConvaTec's Customer Interaction Center at 1-800-422-8811.

Ostomy Access Program is a registered trademark of ConvaTec Inc.


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