Will Medicare Pay for a Walk-In Bathtub?

Will Medicare Cover Any of the Cost of a Walk-In Bathtub?

Drawing upon vast industry experience, Ella’s Bubbles seeks to educate Medicare recipients about the financial assistance available for the purchase of one of our state-of-the-art walk-in bathtubs.

The advantages of a walk-in bathtub for the health and safety of most senior citizens begs the question — will Medicare cover some or all of the costs? After all, bathing in a walk-in tub with therapeutic jets has been proven to improve mobility, invigorate the skin, aid digestion and organ health, and reduce pain.

Despite the benefits, the answer is usually “no.” Neither the purchase or installation of a walk-in tub is typically covered by Original Medicare — that is, Medicare Part A or Medicare Part B as established by law and managed by the Federal Government.

Original Medicare does cover “durable medical equipment,” but walk-in tubs do not qualify based on established standards. There is nothing to be gained in arguing this point — Original Medicare has repeatedly declined to recognize this classification for walk-in tubs.

Very rare exceptions have been recorded. To have a chance of financial assistance from Original Medicare in your purchase, you will need to obtain a diagnosis from your doctor that cites a walk-in tub as a medical necessity. The diagnosis must be accompanied by a prescription that spells out clearly why the walk-in tub is required for treatment.

There is no guarantee that Original Medicare will accept such a claim even in the presence of the diagnosis and prescription. It is safest to treat your walk-in tub purchase and installation as an out-of-pocket expense or to seek other forms of assistance. Submit your claim and see what happens — luck could be on your side.

In any case, Original Medicare will never advance any portion of the cost of acquiring a walk-in bathtub. If financial assistance is approved, it will always come in the form of a reimbursement. If this is outside of your comfort zone, original Medicare is not the right avenue to pursue financial assistance.

Bear in mind that while these restrictions exist on the level of Original Medicare, Medicare Advantage (MA) plans may be a different story. Sometimes referred to as “Medicare Part C,” MA plans are run by private insurance companies, contracted by Medicare to provide all Part A and Part B services to subscribers but not directly administered or paid for by Medicare.

Different MA plans are available depending on where you live. Medicare recipients with End-Stage Renal Disease are not eligible.

Where MA plans get interesting for walk-in bathtub shoppers is the April 2018 announcement by the Center for Medicare and Medicaid Services (CMS) expanding the mandate of MA plans to include “health-related supplemental benefits.” This is vague wording, but it would seem to refer to preventative, diagnostic, and quality-of-life concerns outside of the scope of Original Medicare. In theory, MA plans should have the discretion to cover the cost of a walk-in bathtub without adhering to the standards set by Original Medicare.

Benefits will vary by plan and by state. If you are Medicare-eligible and aspire to own a walk-in bathtub that Medicare pays for, it is worth looking into the MA plans available in your area that you might be eligible for, and inquire as to the provider’s policy for providing financial assistance for walk-in bathtubs.