If you’re planning to age in place—living at home safely and independently—home modifications like walk-in tubs can be essential. These upgrades, however, can be expensive. Understandably, many older adults turn to Medicare to help cover the cost of safety-enhancing items.
A walk-in tub can significantly reduce the risk of falls, especially as the bathroom is a place where many accidents occur. But will Medicare pay for one?
What Medicare Covers
In most cases, Original Medicare (Parts A & B) and Medigap (Supplemental Insurance) do not cover walk-in tubs. That’s because Medicare typically covers durable medical equipment (DME)—things like walkers, wheelchairs, and hospital beds—when prescribed by a doctor. Walk-in tubs, however, are not classified as DME.
To qualify as DME under Medicare, the item must:
- Be prescribed by a Medicare-approved doctor as medically necessary
- Include a written order detailing why the item is needed and what features are required
- Be purchased from a Medicare-approved supplier
Since walk-in tubs don’t meet these criteria, they’re generally not eligible for Medicare reimbursement.
Why Walk-In Tubs Matter
Despite the lack of Medicare coverage, walk-in tubs can be incredibly beneficial. The leading cause of injury among seniors, falls cost the U.S. healthcare system over $31 billion each year, and the bathroom is a frequent site of injury for older adults. If you’re considering one, start by learning how to choose the best walk-in tub for your needs.
Medicare Advantage (Part C) and Walk-In Tubs
Medicare Advantage (MA) plans—offered by private insurers—sometimes cover services and items not included under Original Medicare. These plans may offer extra benefits like dental care, vision coverage, or even over-the-counter (OTC) allowances.
If your plan includes an OTC benefit, you might be able to use it to help pay for a walk-in tub. Contact your Medicare Advantage provider directly to find out:
- Whether walk-in tubs are covered
- What documentation (such as a doctor’s prescription) is required
Medicaid May Help—Depending on Your State
Medicaid eligibility and benefits vary by state. Some states offer Home and Community Based Services (HCBS) waivers, which are designed to help people remain in their homes rather than move to long-term care facilities.
If you qualify for Medicaid, you may be eligible for help with the cost and installation of a walk-in tub. It’s important to talk with your Medicaid caseworker first to understand:
- If your state’s Medicaid program offers this support
- What documentation you’ll need
- Whether funding is available
For more details, visit the Medicaid.gov State Overview to find contact information for your state.
Eligible Veterans may Qualify for Home Modification Assistance
If you’re a veteran, you might qualify for a Home Improvements and Structural Alterations (HISA) grant through the Department of Veterans Affairs (VA). These grants help veterans with service-connected (and in some cases, non-service-connected) medical needs make necessary home modifications.
To be eligible:
- A VA physician must prescribe the home modification as “medically necessary”
- As of 2021, the lifetime cap for HISA grants is $6,800
You can use HISA funds to:
- Install or modify essential bathroom features, like walk-in tubs
- Upgrade plumbing or electrical systems for medical equipment
- Modify entrances, sinks, counters, and surfaces
- Improve pathways or install ramps
Veterans should contact the VA to see if they qualify and begin the application process.
Affordable Alternatives to a Walk-in Tub
What happens if you’re not eligible for any monetary assistance and can’t afford a walk-in tub or you can’t install one for other reasons – such as living in a rental property? There are alternatives to a walk-in tub that can make your self-care easier and safer.
- Shower chair: The price for a shower chair or stools ranges from $30-$300 depending on the type and options you choose. Most are portable, but some models can be attached to the wall of the tub or shower for extra stability. The portable ones don’t require any structural renovation, and you can take them with you when you travel or move to a new residence. Learn how to choose the best shower chair for your needs.
- Grab bars: Place them in the shower/tub area and nearby to help prevent falls.
No matter what your age, bathrooms can be dangerous places. Walk-in tubs, shower chairs, grab bars, raised toilet seats, and other safety equipment can help prevent dangerous falls. However, if the worst happens, make sure you have a way to call for help.
Bay Alarm Medical specializes in medical alerts that you don’t have to wear. With our standard or wall-activated wall buttons, help is just a call away. You can easily summon help by pulling a cord, pushing a button, or simply telling the system to “Call 9-1-1.”
Contact us at 1-877-522-9633 to learn more about Bay Alarm Medical alert systems and how you can try one risk-free.
