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Toll Free: 1-888-244-0789











By submitting this form, I authorize Liberator Medical Supply, Inc. to contact me by telephone and/or email. We value and protect your privacy.


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Toll Free # 1-866-625-0169









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on all Medicare, Medicaid and Private Insurance orders.





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Insurance Compatibility Form

Find out if your insurance provider is part of the Liberator Catheter Supply-Care network.


The Liberator Catheter Supply Care Program works with Medicare, Medicaid and a wide range of private insurance providers. To qualify for the Catheter Supply-Care Program, verify your insurance coverage and qualify for Single-Use simply fill out and submit the form below. Or call 1-888-244-0789. A Catheter Supply-Care Specialist will call you to discuss your catheter product preferences and insurance reimbursement qualifications. Please be assured that we value and respect your privacy. All information is strictly confidential, secure and private. To review our privacy policy click here.

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By providing my phone number, I am agreeing to have a representative contact me to confirm my Catheter Supply-Care qualification and provide assistance and Catheter Supply-Care information.

Insurance Forms

Providing you with the absolute best service and support is our first priority. We look forward to the opportunity to prove to you that we are the ideal resource for your Healthcare at home. Help us speed up your order by signing and returning the Assignment of Benefits & HIPPA and the Authorization for Disclosure forms.

Assignments of Benefits and HIPPA

Authorization for Disclosure


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Click links below for more information on: Types of Catheters
Catheter Bag CareCatheter CareCatheter InsertionCatheter Supply CareSelf Catheter Care
Female Catheter Information: Types of Female Catheters
Female Catheter CareFemale Catheter InsertionFemale Urinary CatheterFemale UTISpeediCath CompactCure Twist
Foley Catheter Information: Foley Catheter Types
Foley CathetersFoley Catheter CareFoley Catheter InsertionFoley Catheter Removal
Male Catheter Information: Types of Male Catheters
GeeWhiz Male External CatheterMale Catheter InsertionMale Urinary Tract Infections
Additional Catheter Information: Catheter Types
Catheter InsertionCatheter PainFemale Catheter InsertionIntermittent CatheterizationMale Catheter InsertionWhy have a Catheter Supply Care Plan?
Incontinence Solution : • GeeWhiz Male External Catheter
Other Information :
Product Images and DescriptionsInsurance Providers

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