Does Medicare pay for walk-in bathtubs?

Medicare doesn’t usually cover walk-in bathtubs. The United States federal government’s healthcare program doesn’t consider a walk-in bathtub to be durable medical equipment (DME). Therefore, it will not pay for the cost of the tub itself or the cost of installing the tub. And those costs add up. Basic walk-in tubs cost between $1500 and $3000. Wheelchair-accessible tubs cost more, typically in the $3500 to $5000 range. Installation costs vary based on the design of your home. However, you can expect to pay for a minimum of four to eight hours of skilled labor for plumbing, tile work, and old equipment removal.

As per usual with Medicare, though, there are exceptions to every rule. If you as a Medicare beneficiary can prove that a walk-in tub is a medical necessity, there is an outside chance that Medicare might assist you with a portion of the cost. This is typically done via the written endorsement of a physician or other qualified healthcare professional. In this case, the assistance would likely take the form of reimbursement. That means that you would have to pay the full cost of the walk-in bathtub and any installation costs up front. You’ll need to thoroughly document the need for the tub with the assistance of your doctor, then purchase the tub as an out-of-pocket item, submit a claim to Medicare, and hope for the best.

Medicaid is more likely to provide financial assistance on walk-in tubs than Medicare. Unlike the federal government’s Medicare program, Medicaid programs vary by state. So the rules and regulations for obtaining walk-in tub financial assistance may vary depending on where you live. Some Medicaid programs (such as Colorado’s) feature an Elderly, Blind, and Disabled Persons Waiver. This waiver pays for specialized medical equipment and accessibility modifications to a residence. If you and your doctor can prove that a walk-in tub is medically necessary to help you continue living in your home, your state Medicaid program may pay for the equipment and the installation. Consult with your local Medicaid office to determine if your state offers Home and Community Based Services waivers that can be used to your benefit.

Assistance for veterans, low-income

You might also consider contacting the Veterans’ Administration if you are a military veteran in need of financial assistance with a walk-in tub. The VA offers three grants for disabled vets:

  • the Specially Adapted Housing Grant
  • the Special Home Adaptation Grant
  • the Home Improvements and Structural Alterations Grant

Your VA representative should be able to assist you in determining whether or not any of these programs can be used to address your walk-in tub needs. You should also ask your VA contact about the Veterans Directed Home and Community Based Services program. That program is modeled on Medicaid’s Home and Community Based Services program mentioned in the previous paragraph. The VD-HCBS provides veterans with a certain budget which may be spent at the veteran’s discretion on services and supplies related to home health care.

VA Aid and Attendance, Housebound, and various other Veterans Administration pensions could theoretically be used to cover the costs of a walk-in tub. The pensions have no specific purpose and thus could be used to pay for purchase and installation costs for the tub. Additionally, the cost of the tub could be deducted from the veteran’s income, which could lead to a larger pension benefit.

Other resources include a U.S. Department of Agriculture grant that assists elderly low income patients with home modifications, state-specific elderly assistance programs, and community assistance organizations.

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