Does Medicare Cover Walk-In Tubs?Learn about Medicare’s coverage for mobility aids such as walk-in tubs.
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The Medicare program helps millions of senior Americans with their health care costs. However, people often wonder what they can get covered and what is excluded under Medicare.
One coverage question is whether or not Medicare will pay for walk-in tubs. These devices can be helpful for people who struggle to bend down, move, or climb into a regular bathtub.
Read our guide to find out what kind of coverage Medicare will offer you for walk-in tubs and other options you can look into if it doesn’t.
What Is a Walk-In Tub?
A walk-in tub is a specially designed bathtub that allows a person to walk into the bath. These tubs usually have doors that open and then seal again when closed, which allows the tub to fill with water.
There are several different types of walk-in tub manufacturers out there and you can even order custom sizes or designs depending on your needs.
Will Medicare Pay for a Walk-In Tub?
While Medicare does cover certain kinds of DME (durable medical equipment), it will generally not cover a walk-in tub as it is not an absolute medical necessity.
DME is any kind of equipment that is medically necessary and which will be used for an extended period of time to help in the relief or treatment of symptoms of a covered disease.
Some examples of covered specialized medical equipment, include:
The process for getting durable medical equipment covered through Medicare means you’ll need to speak to your doctor who will recommend that you need a specific piece of approved medical equipment.
The Centers for Medicare and Medicaid (CMS) will then determine whether or not your condition requires the equipment to relieve or reduce your symptoms.
Unfortunately, walk-in tubs are not on the approved list of DME devices and this means you won’t be able to get your tub covered by Medicare Part B.
What Is Medicare Part B?
Medicare Part B covers out-of-hospital medical expenses such as tests, screenings, visits to the hospital, and certain kinds of durable medical equipment.
Part B coverage is not compulsory and in order to have Part B coverage, you’ll need to pay a monthly premium (the standard premium is $170.10 in 2022).
If a cost is covered by Medicare Part B, you’ll generally pay:
20% of the total cost.
Medicare Part B deductible ($233).
Medicare will then pay 80% of the bill. For example, let’s say you go to the doctor because of an injury. The bill comes to $250 for your exam and treatment.
Once you’ve paid your Part B deductible, your doctor will submit your bill to the CMS and they will pay 80% ($200). You will then have to pay $50 of the cost of treatment.
If you are concerned about maintaining personal hygiene and have mobility or strength issues, speak to your doctor about steps you can take to improve your hygiene routine at home.
In some cases, it may be necessary to get assistance from a nurse or health care provider at home. Medicare will cover some of the cost of this, so be sure to ask your doctor about it.
Getting Professional Help for Severe Physical Impairment
Walk-in tubs are generally used in home health care settings to improve the quality of life for people with mobility and strength issues.
However, if the condition or disease has reached a point where you or a loved one is struggling with everyday activities, then looking at full-time care in a nursing home or hospice might be necessary.
These facilities will typically have the necessary equipment to deal with daily tasks and activities, and are covered by Medicare Part A.
Find out more about this by reading our article on hospice coverage.
Will Medicare Advantage Pay for a Walk-In Tub?
Private insurance companies will not cover the costs of getting a walk-in tub as durable medical equipment. The cost of this device will need to be covered in full by the member who wants to get it.
If you have private Medicare coverage, you should ask your provider what equipment they might cover to help you with home health care. This will be in line with what Original Medicare offers its beneficiaries; however, your plan might provide additional coverage for certain expenses.
For example, many Medicare Advantage Plans offer their members SilverSneakers benefits. The SilverSneakers program is aimed at older adults who are looking to maintain their fitness levels and remain active as they age.
There are also state-specific options such as Medicaid programs or community based services which may cover some of the costs of a walk-in tub, or at least provide alternatives for people that need help entering and leaving a bath.
You should check with your local SHIP (state health insurance program) to see what your options are if you would like to get assistance with at-home health care costs.
Conditions and Diseases That Can Cause Mobility Issues
While there are hundreds of conditions that may cause mobility issues, here are a few common examples:
Spinal Cord Injury.
Another major cause of mobility issues for Medicare beneficiaries is age.
Costs to Think about with a Walk-In Tub
Walk-in tubs can cost thousands of dollars and you can pay anywhere from $2,000 to $12,000 for the tub alone.
Besides the price of the unit, there are some other costs that you’ll need to consider if you’re thinking about getting a walk-in tub.
Installation costs are usually billed separately and the installers may need to alter your bathroom area to fit the new tub inside.
You can expect to pay anywhere from $2,000 - $11,000 to have a walk-in tub installed in your home.
A contractor may need to:
Install a water heater.
Clear or replace drains or piping.
Replace tiles and drywalling.
Widen the door to fit the new tub inside the bathroom.
Ongoing maintenance and plumbing issues are things you should think about with a walk-in tub. These costs can add up over time, so be aware of this before you commit to buying and maintaining a walk-in tub in your home.
As you can see, getting a walk-in tub can be very expensive and while some manufacturers and contractors do offer payment plans, the costs are generally quite high.
Alternatives To A Walk-In Tub
There are alternatives out there if mobility is an issue and you want to maintain your hygiene routine at home. Let’s take a look at a few:
A bathtub lift
A bathtub lift is a specially designed home health care device that allows a person to be lifted into and out of a bathtub.
These devices are more affordable than walk-in bathtubs and won’t require major alterations to your bathroom.
A shower chair
One option that people with mobility issues use to help them with bathing is a shower chair that can be placed in your shower.
These devices are low-cost and lightweight, which make them perfect for many people who can’t stand for extended periods.
While these devices aren’t covered by Medicare, they are much more affordable than a walk-in tub.
This makes them the perfect option for those with smaller budgets or for people who have long-term health care needs that will stretch their resources.
Our Verdict on Walk-In Tubs and Medicare
Seeing as Medicare won’t cover the cost of purchasing, installing, or maintaining a walk-in tub, you’ll have to fund this on your own.
Walk-in tubs are very expensive and there are hidden costs that you’ll need to consider when you buy one.
However, there are other devices that you can use if you have mobility or strength issues and you need to get into the bath or shower. These devices may be covered by Medicare or your private health insurance, so look into these before you make a decision.
Before deciding to install a walk-in tub, be sure to speak to your doctor about your options or reach out to your local SHIP (state health insurance program) to find out whether or not you can get assistance with your home health care.
Walk-In Tubs and Medicare FAQs
Does Medicare cover walk-in tubs?
No, Medicare does not classify walk-in tubs as medically necessary durable medical equipment. Because of this, Original Medicare and Medicare Advantage won’t cover a part or all of the costs of a walk-in tub.
What is an alternative to a walk-in tub?
There are a number of alternatives to a walk-in tub that you can try if you struggle with mobility, including a bathtub lift and a shower chair. Both of these options are more affordable than a walk-in tub.
What is the average cost to install a walk-in tub?
You can expect to pay anywhere from $2,000 to $10,000 depending on the amount of work required to fit and install a walk-in tub in your home. This can include removing drywalling, replacing tiles, and altering your bathroom layout for the walk-in tub.
Are walk-in tubs worth it?
If you suffer from a condition or disease that affects your mobility, then a walk-in tub can be a great help. However, there are alternatives that are more affordable if you don’t have a large budget to spend.
Where Can I Learn More about Medicare and Coverage?
Walk-in tubs are just one option that people can look at if they want to improve their quality of life, but suffer from mobility issues. However, these devices aren’t covered by Medicare and can cost thousands of dollars to buy, install, and maintain.
If you’re interested in finding out what Medicare will pay for, then visit our Medicare hub to see our latest articles on coverage, costs, and enrollments.
Speak to one of our Medicare agents today if you’re interested in making the change to Medicare Advantage and want to find a plan in your area. Reach out at 1-888-912-2132 or send an email to Help@PolicyScout.com to get started.