December 13th 2024
By Ari Parker
Medicare doesn't generally see walk-in-tubs as medically necessary and they aren't covered by Part A or Part B. Learn more in this article.
More than one in four people aged 65 years or older have a fall each year. Up to 80% of those falls occur in the bathroom.
A walk-in tub can reduce a major fall risk, but will Medicare pay for it? Unfortunately, the answer is usually "No." Despite their safety benefits, walk-in tubs typically don't meet the criteria for health insurance coverage.
A walk-in tub is a specially designed bathtub with a built-in door that swings open, allowing users to step directly into the tub instead of climbing over the side. This feature makes bathing safer and easier for seniors and individuals with mobility challenges.
Walk-in tubs include several safety features that can help prevent falls, including:
A low threshold for easier access
Built-in seating
Non-slip surfaces
Grab bars and handrails
While research hasn't directly proven that walk-in tubs reduce falls, many Americans are opting to install them to help stay safe in their bathroom as they age.
Typically you’re looking at costs between $3,000 and $10,000 for a safe, fully installed walk-in tub. The cost of a walk-in tub can be much higher though, stretching to $20,000 for some luxury models or if a full bathroom remodel is needed for installation.
Installation costs average out at about $1,500 but it depends on the plumbing, electrical and remodeling work that’s needed to fit the tub.
While the installation of a walk-in tub can be done yourself, most homeowners choose professional installation due to the complex plumbing and electrical requirements.
Medicare benefits cover medically necessary equipment and supplies. Walk-in tubs might make taking a bath easier and safer, but Medicare doesn’t consider them to be necessary and doesn’t cover them under Part A or Part B.
However, there may be very rare exceptions if a doctor can document a specific medical need for a walk-in tub.
Medicare treats walk-in showers like it does walk-in tubs and generally will not pay for this bathroom upgrade.
No, Medicare plans don’t consider walk-in tubs as durable medical equipment (DME). While walk-in tubs can improve safety and accessibility for seniors, they are not used for medical treatment.
Original Medicare and Medicare Supplement insurance plans tend to consider adding a walk-in tub a home improvement, not a medical expense.
Medicare Advantage (Part C) plans include extra benefits beyond those covered by Original Medicare. Extra benefits that come with Medicare Advantage plans can include coverage for some home modifications, but this is not common.
To find out if your plan covers walk-in tubs:
Contact your plan’s carrier directly to ask about coverage for home safety modifications
Ask your doctor to document why a walk-in tub is medically necessary for your situation
Get details about any coverage limits or requirements before making a purchase
The cost of a walk-in tub or walk-in shower, including installation, may be tax-deductible as a medical expense if a doctor prescribes it for medical reasons.
Some states offer tax credits or deductions for home modifications aimed at enhancing accessibility and safety for yourself or an aging parent who moves in. These programs vary widely between states. Before making a decision, consult with a tax professional to determine your specific eligibility.
Medicaid: Medicaid programs in some states may help cover the cost of walk-in tubs, especially for low-income individuals who meet specific eligibility criteria. There are hundreds of state Medicare waiver programs that justify the tubs.
Veterans benefits: Veterans with TRICARE and CHAMPVA insurance might have trouble getting authorization for walk-in tubs, but the Department of Veterans Affairs offers several home modification loans to add ramps, widen doors, and even install a walk-in bathtub.
Other financial assistance: Explore other financial assistance options, such as grants, loans, and tax credits for home modifications available in your area. Your doctor and other healthcare professionals can determine if a walk-in tub is medically necessary for your needs. Additionally, research various financing options and explore potential tax deductions to help offset the cost.
Get in touch with a Chapter Medicare Advisor to understand all of your Medicare benefits. Get in touch with an agent at 855-900-2427 or schedule a time to chat.
