Medicare and Medicaid Coverage Cost Review

Medicare-and-Medicaid-senior-bathing

One of the first questions we get asked is whether or not the installation of the walk-in tub will be covered by Medicare and Medicaid. The short answer is, no…BUT…there are some exceptions. And it’s important to keep in mind also that Medicare is not your only option.

Why Won’t Medicare Cover a Walk-in Tub?

Although it might be deemed a medical necessity for some people, especially seniors and others with limited mobility problems, original Medicare does not categorize walk-in tubs as durable medical equipment (DME) most of the time. Another reason is the fact that it involves a physical change to the home, rather than an addition.

Having said that, there are some situations that might still qualify for some coverage, providing it is an absolute medical necessity.

How To Qualify for a Medicare Walk-in Tub

If you are eligible for Medicaid, and you have a prescription for your doctor stating that it is an absolute necessity, your state might offer programs that have financial assistance for a walk-in tub. And while it is not a guarantee, there is a slim chance of some financial support from Medicare Part B.

Medicare Plan B

Part B of Medicare provides coverage for necessary and preventive services. This includes a second opinion Senior-bathingbefore surgery, ambulance services, clinical research, mental health, and also DMEs, provided you have the necessary documentation from your physician.  Only your doctor will be able to highlight the medical need for a walk-in tub, which can make you eligible to receive reimbursement for a portion of the price.

Patients rarely receive coverage for it, however, and the cost of installations are not covered either. Also important to remember is the fact that reimbursements only takes place after the initial order of the walk-in tub has been made. The paid invoice can then be submitted along with your prescription and other supporting documents from your physician including dates and signatures, and a clear diagnosis as to why the walk-in tub should be considered. Medicare really needs to be completely satisfied that the tub is a medical necessity before they will accept any claims.

What Are My Other Options?

Medicare Advantage Plan – Part C

Medicare currently has numerous options for their Advantage Plan, including Parts A, B, C, D, F, G, K, L, M and N. The part that should be of particular interest and offers the best chance of receiving some form of reimbursement for the installation of a necessary walk-in tub is Part C.  This part stipulates that private companies approved by Medicare may offer to cover the cost of a walk-in tub .

Medicaid Supplemental Healthcare Benefits

As of 2019, Medicaid offers new supplemental healthcare benefits, which is very similar to the Medicare Advantage Plan. Instead of being a single Federal program, there are many State programs which are governed by a multitude of different rules that include Medicaid HCBS waivers. You should examine the benefits of your state’s Medicaid waivers to establish your options for installation of a walk-in tub.

VA Benefits and Grants

Although it is impossible to say with surety that the VA will assist with paying for a walk-in tub, or any sort of home modification to your home for that matter, they do have a number of programs that might be able to assist and worth checking out. These include:

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Tax Deductions

You might be able to claim a tax deduction on your walk-in tub, but this will depend on a few things and has to be for treatment or prevention of disease and not merely beneficial for general health.

However, should the tub be purchased for medical safety reasons, it can be considered a medical expense and homeowners could make a claim under the Dependent Care Tax Credit.

So, although Medicare does not unequivocally cover for the installation of a walk-in tub, there are several acceptions and several options to explore that could help pay for the installation of a walk-in tub.