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“Medicare covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessary to treat a disease or condition.” - Medicare.gov
With a little help from your medical insurers, a walk-in tub that is heavy with therapeutic features can be very affordable. Reading our four points below will help you get started on learning the basics about durable medical equipment, the Medicare Advantage Plan, and Medicaid.
Walk-in bathtubs do not qualify as durable medical equipment (DME) by Medicare’s standards, and for this reason, seniors have a very slim chance of attaining financial support from Medicare’s Part B. Walk-in tubs are seen as luxury items by Medicare and not necessary medical equipment.
Part A of Medicare covers expenses for home health services, hospice, nursing home care, skilled nursing facility care, and hospital care. Part B of Medicare covers medically necessary and preventive services like clinical research, ambulance services, durable medical equipment (DME), mental health, getting a second opinion before surgery, and limited outpatient prescription drugs. While a patient will be required to provide documentation of their diagnosis as well as a doctor’s prescription that highlights a senior’s medical need for a walk-in tub, patients rarely receive coverage for it, neither its installation costs, under Medicare plans.
There are ten Medicare Plans that you could choose from: A, B, C, D, F, G, K, L, M and N. The best and most cost-effective option that might support the purchase of a walk-in tub is Part C because it covers all the standard medical services of Parts A, B and some of D, except for hospice care. Part C is a Medicare Advantage Plan where private companies approved by Medicare may offer to cover the cost of a walk-in tub because their policies differ from one state’s laws to the next. The best way to make sure if your plan will cover a walk-in tub or its cost of installation is to ask for an “advance coverage decision” from your insurance company.
Medicaid acts like a Medicare Advantage Plan because its policies are governed by state laws, which means there are many more sets of rules that determine Medicaid coverage of walk-in tubs. Walk-in bathtubs are referred to as “low threshold showers” for seniors that need “environmental accessibility modifications” done to their homes in order for them to complete domestic tasks that they couldn’t otherwise perform. This requires proof in the form of a diagnosis and a prescription for a walk-in tub provided by a certified physician. Medicaid guidelines are governed by state laws - to find your state’s Medicaid program, click here.
If you can't get help from either institution, there are other ways to help you drive the price of a walk-in tub down: