Walk-in bathtubs are not classified as durable medical equipment, so in most cases, original Medicare will not cover the cost of a tub or its installation. However, there are exceptions to this rule if the tub is considered medically necessary. In addition, Medicare Advantage may sometimes cover the cost of this type of equipment.
Many seniors find walk-in tubs useful because they are easier to get into and out of. Seniors may opt to have a walk-in tub installed so they can remain in their home longer, tend to personal hygiene independently and delay the need to move to an assisted living facility.
Medicare advantage covers the costs of certain types of durable medical equipment. Walk-in tubs are covered only if they are classed as being medically necessary. To prove necessity, a beneficiary would need to submit evidence of a medical diagnosis proving that need and a prescription specifying why a walk-in tub is required.
The prescription should also outline any specific features the tub should have, especially if those features mean the beneficiary would need to purchase a particular brand or model of bathtub. Original Medicare will not cover the cost of a tub up-front. The beneficiary must purchase the tub as an out-of-pocket expense and then submit the receipts for the purchase along with the evidence required for their claim.
Medicare Advantage is an expanded form of coverage that is regulated by Medicare but managed by private insurance companies. Some Medicare Advantage plans offer broader coverage for health-related supplemental benefits, which means individual insurers may be willing to cover things not included in original Medicare.
Each insurer has the right to exercise discretion about what items they cover beyond the things required by Medicare, but “health-related supplemental benefits” includes items that can be used to:
A senior could argue that a walk-in tub helps mitigate the impact reduced mobility has on their life, reduces the risk of injury and helps them retain their independence for longer.
Medicare is not the only form of assistance available for seniors. Many states and local authorities offer additional waivers or programs aimed at helping seniors remain in their own homes, living safely and independently for as long as possible. Contact a local Aging and Disability Resource Center for more information about what’s available in your area.