Incontinence Home Ship Program

Do you have a patient that would benefit from our Mississippi Medicaid incontinence home ship program?

You can refer them using the form below. After receiving a referral, our customer care team will contact the physician for any necessary prescriptions and documentation. We will also contact the patient or caregiver to handle any paperwork.

If you prefer, you can also refer a patient by downloading the PDF below and emailing it to mdmedical@mdmed.org or by faxing it to (601) 992-4564. If you have questions, please call our customer care team at (601) 919-9196.