Requirements for Medicare Coverage of Walk-In Bathtubs

themes making most retirement
Themes for Making the Most Out of Retirement, Part 2
February 7, 2020
walk-in tub timing elements
Walk-In Tub Purchase Timing Elements, Part 1
March 6, 2020
Show all

Requirements for Medicare Coverage of Walk-In Bathtubs

Medicare coverage walk-in bathtubs

For many over the age of 65, or certain individuals who are eligible, Medicare is a vital US government program for helping cover the costs of various health care services. It can cover a huge variety of care areas, with several specific health plans as part of its overall umbrella depending on the needs of the individual.

At Heavenly Walk-In Tubs, we regularly are asked by our prospective clients whether their Medicare program will cover the costs of one of our quality portable walk-in bathtubs. This is a slightly more complex question to answer than you might think – here are all the basics you need to know, including the requirements that must be met for Medicare to cover a walk-in bathtub.

“Durable Medical Equipment” Definition

When it comes to Medicare and whether it will cover the cost of a given piece of equipment, such as a walk-in bathtub or many other potential types, the language to consider is whether the piece is considered “durable medical equipment.” These definitions stem from the original version of Medicare, one that’s still followed in several important ways.

Unfortunately, in most cases walk-in bathtubs are not considered durable medical equipment under original Medicare. This means original Medicare will not pay for their cost or their installation. However, this does not mean there is no chance for Medicare financial assistance for a walk-in tub, as we’ll detail below.

Medicare Reimbursements and Requirements

In some cases, Medicare will provide financial assistance for walk-in bathtubs in the form of reimbursement rather than payment in advance. There are a couple conditions that must be met for such reimbursement to be a possibility:

  • The tub must be considered an absolute medical necessity, with a medical diagnosis that proves the individual’s need for the tub.
  • A written prescription must be given that outlines the reasons for the tub and any features required in the tub.

It should be noted that even when meeting these conditions, not all walk-in tub installations will be reimbursed by Medicare.

MA Plans and Supplemental Benefits

Now, patients should also be aware that there are additional programs on top of original Medicare that may benefit them here. Specifically, we’re talking about Medicare Advantage (MA), a program regulated by Medicare but run by private insurance companies that has expanded supplemental health benefits. Such benefits, which have been updated multiple times in recent years, have continuously expanded coverage for services or items that help prevent, diagnose or treat a disease or injury, including recent upgrades for those with chronic illnesses.

Based on these changes, many MA plans will cover the cost of walk-in tubs. As this program continues to expand, the number of plans that cover walk-in tubs and similar items only figures to grow.

For more on Medicare coverage for portable walk-in bathtubs, or to learn about any of our quality tub options, speak to the staff at Heavenly Walk-In Tubs today.