Understanding Medicare and Medicaid’s Policies on Walk-In Tubs

A walk-in tub can make a world of difference for those with limited or reduced mobility. They can allow you to take care of your hygiene needs independently while improving your bath and shower safety. Because of how essential these tubs are, it might seem like a no-brainer that they would be considered a medical necessity and covered by Medicare or Medicaid. However, the truth is a lot more complicated than that. Keep reading to learn more about these programs’ policies regarding walk-in tubs.

Medicare

Having a walk-in tub partially covered by an original Medicare plan is extremely difficult, but not impossible. To be a possibility, you would have to prove that the tub is an absolute medical necessity. This means having an official diagnosis and prescription from your doctor that outlines why the tub is necessary; they should also include any specific features required for treating the diagnosed illness or injury.

Even with all of this supporting evidence, there is no guarantee that Medicare will pay for part of your tub. However, if they do, it would come in reimbursement, not an upfront payment. So, it never hurts to file a Medicare claim and hope for the best.

If you have a Medicare Advantage program (a new option rolled out beginning in 2020), there’s a higher chance that you can have your tub partially paid for. MA plans have supplemental benefits and can help pay for items that “make up for physical injuries/weaknesses.” If you have an MA plan, you should apply for financial support.

Medicaid

Medicaid is more likely to offer financial assistance for walk-in tubs than Medicare (even with MA benefits), but the guidelines and requirements will vary from one state to the next. You must research the Medicaid programs in your state to see if a walk-in tub would be covered. The most likely option for covering this cost is a Medicaid program known as a Home and Community-Based Services (HCBS) waiver. If your state offers these waivers, the chances are good that your tub can be at least partially covered.

Veterans Benefits

The VA offers many programs to support veterans, but will they cover the cost of walk-in tubs for veterans? Unfortunately, it’s unlikely that TRICARE and CHAMPVA will cover these costs. However, if you qualify for a home modification grant (e.g., a SAH grant, SHA grant, or HISA grant), those funds can be used for purchasing and installing a walk-in tub. You can speak to a representative at the VA to learn more about these grants.

If you’re considering purchasing a walk-in tub, take advantage of as many programs as you can to minimize your out-of-pocket costs.

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