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March 2, 2021
One of the most common questions I get from clients is how to prepare a home for older age. Many baby boomers are opting to age in place, meaning they will remain in their homes as they continue to get older. To accomplish this safely and comfortably, you’ll want to make some accommodations. Some updates to consider are ones to the bathroom, where falls tend to take place.
Bathroom updates can include bars to hold onto, toilets that are easier to sit on, and walk-in bathtubs that eliminate the need to step over a higher rim. With that said, walk-in bathtubs are not inexpensive.
While Medicare will help cover some equipment––hospital-grade beds or oxygen concentrators––it won’t cover everything. On this page, we’ll examine whether or not Medicare covers walk-in bathtubs, and we’ll also take a look at other ways to pay for these life-saving devices.
Between 2010 and 2020, the number of people over the age of 55 grew by 27 percent with approximately 18 percent of the population enrolled in Medicare. Most older adults turn to their Medicare coverage to help them afford healthcare and medications as they age.
Walk-in bathtubs are an effective way to prevent falls; however, in most cases, Medicare won’t cover the cost because Medicare doesn’t consider walk-in bathtubs to be durable medical equipment.
Durable medical equipment, according to Medicare, is equipment that helps you complete daily tasks and can withstand multiple uses––equipment that isn’t helpful to those who aren’t sick or disabled.
Examples of durable medical equipment (DME) include wheelchairs, walkers, and oxygen concentrators. Because anyone can benefit from a walk-in tub, even those who aren’t disabled, Medicare doesn’t include it in their list of DME, meaning Medicare usually won’t cover the cost of the walk-in tub or tub installation.
You should know: Medicare does not consider a walk-in bathtub a piece of durable medical equipment making it very unlikely a Medicare plan financially covers that particular piece of equipment.
With that being said, in rare cases, Medicare will reimburse older adults for their walk-in bathtub. However, there is a process to get the reimbursement.
For Medicare to consider reimbursement, you must have a medical prescription from a healthcare provider. The prescription needs to include exactly why you need the walk-in tub and what features you need with it.
For example, I had a client who needed a leg amputated, meaning he could no longer climb into a tub without assistance. This client got a prescription from his primary healthcare physician for a walk-in bathtub, which allowed him to install the tub and receive subsequent reimbursement from Medicare.
Still, he didn’t need one with all the bells and whistles, such as air jets or whirlpool features. Rather, he needed a basic bathtub with a door to get in and out. Medicare will make you prove why you need the extra features, so keep this in mind when picking out the tub.
It’s also important to note, Medicare does not pay upfront for the tub. Instead, they compensate in the form of a reimbursement and the reimbursement isn’t guaranteed. There have been times when clients of mine think they could get reimbursed, but once they submit their reimbursement claim, Medicare denied it, and they were stuck paying for the walk-in tub out of pocket.
FYI: Although a prescription does not guarantee reimbursement from Medicare, failure to obtain one ensures that you won’t receive reimbursement.
Although Medicare doesn’t traditionally cover walk-in bathtubs, there are other means of financial assistance.
About 30 different states offer community transition funds like these, and they’re one of your best bets towards funding a walk-in tub. Before buying a walk-in bathtub, you should check what Medicaid covers in your particular area.
Did You Know: Medicaid offers different program options depending on the state you live in, and some of those programs will cover either part of all of a walk-in bathtub expense. However, you must do your research before buying a tub to make sure you’re eligible for assistance.
If the price of a walk-in bathtub is too much to bear, then here are alternative modifications that can make your bathroom a safer place. Here are some other options to consider:
While walk-in bathtubs are a nice perk for aging at home, they are a more expensive undertaking and they usually aren’t covered by Medicare. Therefore, if you decide on getting a walk-in tub, you will need to budget accordingly, as most likely you’ll be paying out of your pocket.
Hi Linda- have you looked for a bath bench? Or even better, a transfer bench? Depending on the height of your tub, you should be able to find a product to help you into the tub. Also- If you have Medicare and your physician makes a referral, you can have a home safety evaluation by a home health agency and they can recommend specific products for your home. I hope that helps! Amie
Thank you for sharing Carol!