This topic is about a person with an ostomy who is facing a challenge with Medicare's limit on the number of mini pouches they can receive each month. They use a 2-piece system with 7-inch closed mini pouches because longer pouches are uncomfortable due to their height. The issue is that Medicare only covers 60 pouches per month, which is not enough for their needs. Here are some suggestions and insights to help manage this situation:

1. Obtain documentation from a physician or ostomy nurse:
- Medicare may approve more than 60 pouches if a doctor provides a letter of medical necessity. This has helped others receive additional pouches or early shipments.

2. Look into secondary insurance or appeal options:
- A supplemental insurance plan might cover the extra pouches beyond Medicare's limit.
- You can also file an appeal through your state insurance commissioner.

3. Use liners to extend pouch use:
- Consider using Colo-Majic flushable liners or DIY liners made from produce bags to make a single pouch last longer. These liners might be covered by insurance, and suppliers often provide samples.

4. Try drainable or cleanable mini pouches:
- Options include Hollister drainable mini pouches, Hollister Premier drainable pouches, and ConvaTec Natura drainable systems. Some users clean these pouches for reuse.

5. Reduce issues like sticking, pancaking, and splash-back:
- Add a few drops of baby oil, cooking oil, Vaseline, or Coloplast Brava Lubricating Deodorant inside each new pouch. Medicare covers the Brava product.
- To prevent splatter, add water, swish, and empty the pouch over toilet paper or a toilet-seat cover. Keep the vent closed and release gas periodically to avoid pancaking.

6. Support and conceal longer pouches if necessary:
- Use a support garment like the Ostomy Secrets Classic Wrap to shorten and stabilize the pouch. Wearing the pouch sideways under clothing can also help.

7. Manage thick output to reduce pouch changes:
- Add water when emptying the pouch or use a stool softener as advised by an ostomy nurse. For frequent output, consider using an over-the-counter anti-diarrheal.

8. Find alternatives when insurance coverage is insufficient:
- Look for discounted boxes on eBay or from online surplus sellers. Community members may also trade or donate extra supplies.

9. General troubleshooting:
- An ostomy nurse can help adjust the fit of the wafer or suggest accessories to make barriers last longer, reducing the need for frequent pouch changes.