While Medicare doesn’t usually cover convenience items, some Medicare Advantage plans extend coverage to bathroom safety equipment. While you can order a lot of these supplies online, understanding the details of coverage for bathroom equipment is essential when you’re on a budget. Let’s face it, if insurance can cover it, why would you want to pay for it?
Medicare Coverage for Bathroom Safety Equipment
Now, Medicare will cover commode chairs but don’t expect coverage for comfort items. If Medicare does cover the supply you need, it’ll fall under Part B benefits. For example, Medicare will cover supplies that help lower the risk of falls. Supplies include commode chairs, crutches, and walkers. These supplies are Durable Medical Equipment that Medicare considers medically necessary.
Does Medicare Cover Shower Chairs?
Medicare doesn’t usually cover shower chairs. But, some Part C plans may have an over the counter benefit that covers items like shower chairs. Medicare won’t cover bath chairs because they aren’t considered medically necessary, and therefore they don’t classify this supply as Durable Medical Equipment. So, if you have Medicare and you need a shower chair, you’ll most likely pay for the full costs. The cost of a shower chair can range from $15 for a simple chair up to $300 for a more progressive model.
Will Medicare Pay for Bathroom Modifications?
Your doctor may recommend making bathroom home modifications to keep you safe. But, Medicare coverage doesn’t include home modifications. If you need bathroom modifications, you’ll pay out of pocket for the remodel.
Does Medicare Cover Grab Bars?
Medicare won’t usually pay for grab bars, even if they’re a necessary bathroom safety device. Medicare covers bathroom safety devices that are medically necessary, not the equipment that is for comfort. Those with Part C may have some help paying for the cost of grab bars. A simple install where studs are ready for mounting can cost about $75- $150, although a more complex job requiring additional support to the wall could cost more than $200.
Veterans with a prescription to make their homes more secure may get coverage from the Department of Veterans Affairs for shower chairs or grab bars.
Does Medicare cover Raised Toilet Seats?
Raised toilet seats are something Medicare considers a convenience item. However, some Advantage plans find this supply medical, especially in cases where a patient is unable to bathe without being seated if a patient is unable to transfer in and out of the tub.
Anyone can buy a toilet seat with arms and elevation online, sometimes with same-day delivery. Medicare doesn’t cover toilet seat risers; but, many of them are affordable.
Does Medicare Cover Walk-In Tubs?
As of today, Medicare won’t cover a walk-in tub even if it’s a necessary bathroom safety device. Medicare may give partial reimbursement for the cost of a walk-in tub. But, it’s highly likely they deny your request. When remodeling the bathroom, always expect at least another $1,000 towards the budget to cover hidden damage costs. Many contractors find dry rot or other damage after removing an old bathtub.
While it’s unlikely that Medicare will reimburse you for the cost, sending in all documentation about your case isn’t going to hurt. When asking for reimbursement, you need a doctor’s prescription for the supply, all your receipts, and have the doctor sign forms listing reasons as to why the supply is mandatory for quality of life.
You might get approval; you might get denial; either way, prepare to pay for the total cost yourself. Some Advantage plans cover a small portion of the costs. Medicaid is more likely to provide help paying for a walk-in-shower. Each state Medicaid program varies, and if you have a low-income, contact your state program about eligibility.
The Veterans Affairs offers three different grants for home modification for veterans; the Home Improvements and Structural Alterations Grant, the Specially Adapted Housing Grant, and the Special Home Adaptation Grant.
Does Medicare Cover Transfer Benches?
Medicare won’t cover a transfer bench or any bathroom safety device that is for comfort. However, transfer benches can be affordable online. Also, those with Medicaid should talk to their providers about coverage through Medicaid. If you have Part C, check with the insurance provider about possible coverage. Although, sometimes it costs less to buy online than through the Durable Medical Equipment supplier and insurance.
Do Medicare Advantage Plans Cover Bathroom Equipment?
Yes, some Part C plans cover bathroom safety equipment that Medicare doesn’t cover. But, these plans have strict networks, and it’s worth comparing Medigap vs. Medicare Advantage before enrolling. Keep in mind; the policy may only cover supplies under specific conditions. Be sure to take a thorough look at the details of a Part C plan before jumping into a policy.
FAQs
How to Get Medicare Coverage for Bathroom Safety Devices
It's essential to see a doctor that takes Medicare and buy your equipment through a Medicare supplier. When you don't do these two things, you can lose any grain of hope you had for coverage. Some bathroom safety devices may be cheaper to buy online than through a Durable Medical Equipment supplier. Technology allows us as buyers to find the best deal for our situation.
Part C or Medigap can help cover costs. Call us at the number above or fill out an online rate form to find the best policy for you today!
Not covering shower/bathtub seats, and handheld shower heads after bilateral total knee replacement is playing russian roulette with newly placed knees.$60.00 could save $60,000.00 if knees are damaged.
This is ridiulous, I use a wheelchair and I need to bathe sitting down, my chair broke… how is a bathing chair considered as “comfort item” I don’t have the money to get a new chair, so do I need to bathe on the floor now?
Hi Vanessa! I would contact your local SHIP office, they can provide you with some resources that may be able to help with the cost.
I`m so confused- why would Medicare pay for a Nursing facility stay which costs them so much money rather than paying for a one time home modifications such as a ramp or stair lift or bathroom/shower modifications? Often times, by not having the home modified they cant stay home and just go to the facility. The cost to Medicare is often times 10 times more!
I think it is ridiculous as I read this page especially about the grab bars being considered for comfort so you guys are basically telling me that for example my father who had a severe stroke and has no use of his left side which means he medically needs a grab bar to be able to hold himself for safety means nothing that baffles me grab bars for anybody are not for comfort they are so you can be stable
Hi Susan! Yes, I couldn’t agree more with you. This is something that Medicare needs to change. There is no reason they shouldn’t consider grab bars medically necessary regarding your fathers’ situation.
Mom is a 88yr old diabetic who just had a below the knee amputation… she will be in recovery/therapy for the next couple of months. I would like to remodel the bathroom for her specific needs… roll in shower, transfer bench, hand rails, etc… Is she eligible through Medicare for a portion of this to be funded? She does have a supplemental plan as well…
Hi Mike! If these items fall under the category of Durable Medical Equipment, then yes. Part B will cover 80%, then the supplemental plan will cover the remaining 20%. I’m not sure if all the above fall under DME, I would contact her physician and/or Medicare directly to verify. Another great resource is Aero Flow Inc. They might be able to clarify more.
I need safety bars in bathtub for my mom. She is 90 years old and fell down in bathtub
Hi Peggy! Unfortunately, Original Medicare does not generally consider grab bars as Durable Medical Equipment. However, a Medicare Advantage Plan may cover a grab bar or safety rail.