Will Medicare Cover a Walk-In Shower?

Many seniors face mobility challenges, making showering or bathing potentially dangerous. According to the CDC, millions of people age 65 and older fall yearly, and bathrooms remain high-risk areas for accidents. Falls are a leading cause of bone fractures and traumatic brain injury, and you may be wondering if Medicare will help pay for a walk-in shower.

Walk-in showers and tubs enable you or a loved one to feel more secure while bathing and reduce the risk of serious injury. This article will discuss Medicare coverage for walk-in showers and tubs.

Does Medicare pay for walk-in showers?

Although walk-in showers can significantly benefit seniors by making it easier and safer to maintain hygiene and independence, Medicare does not typically cover this equipment. Original Medicare Part B benefits cover durable medical equipment such as CPAP machines, oxygen, or walkers when medically necessary. Unfortunately, except in rare situations, Medicare does not consider walk-in showers medically necessary. Furthermore, installing a walk-in shower can be costly and require a significant remodel. If Medicare were to cover this equipment for all members, their costs would be enormous.

So, where does this leave seniors and their families? Most seniors can expect to pay out of pocket for the added peace of mind a walk-in shower or walk-in tub can provide. However, out-of-pocket costs vary, and you may discover an affordable option by selecting certain models, features, accessories, and installation options. Assistance programs are also available to qualifying individuals planning to install a walk-in shower. So, although Medicare will not help with costs, affordable avenues for walk-in shower conversions are available to seniors.

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What is the cost of walk-in showers for the elderly?

Walk-in showers enable people to bathe while standing. Some models come with seat options, allowing the flexibility to sit when needed. Walk-in showers typically offer a low-step entry, making getting in and out of the shower easier. They have a variety of shower heads and safety features to choose from. Wide entrances, non-slip floors, and grab bars are some other available options, as well as safe storage for bathroom supplies.

The cost of a walk-in shower depends on the model, features, installation, and the extent of any remodeling required.

According to Consumer Affairs, a walk-in shower can cost between $800–$15,000. Some companies can replace a standard bath with a walk-in shower, while other situations require a complete bathroom remodel. Either way, a walk-in shower is a significant financial investment, so consider the features you need and anticipate what upgrades you may require. Companies often offer financing and payment plans to reduce upfront costs. Not all companies provide installation; you may need to factor in the costs to hire a plumber.

Are there any free walk-in showers for seniors?

Other alternative financing options fill the gap Medicare leaves. Although walk-in showers may not be medically necessary by Medicare’s definition, preventing severe injuries and even death from an accidental fall makes walk-in showers appealing to many. However, It is unlikely that you will get a walk-in shower at no cost.

Luckily, you may qualify for financial help from the following assistance programs:

• State assistance programs
• USDA Rural Repair and Rehabilitation grants
• Rebuilding Together

Aside from the above programs, Medicare Advantage and Medicaid may offer seniors financial help when covering walk-in shower conversion costs. Specific coverage details differ according to plans and states, so contact your insurance representative for more information. If your plan provides some coverage for a walk-in shower, find out what paperwork is required before proceeding with a purchase. You should also ask if your plan has any limitations on models or servicing businesses. Insurance may need you to pay all costs upfront and provide reimbursement later, so keep all your records.

What is a walk-in tub? Do I need one?

Walk-in tubs allow you to bathe while sitting. Depending on your mobility issues, walk-in tubs provide a safer option than a standard tub and shower. Typically, walk-in tubs offer several safety features and have a low-rise entry. They are deeper, surrounded by high walls enabling seniors to wash while seated and submerged in water. A walk-in tub may also give caregivers easier access when helping with bathing.

Medicare does not typically cover walk-in tubs for the same reason. Walk-in tubs are not considered medically necessary but rather an optional convenience.

According to Consumer Affairs, a walk-in tub could cost between $ 2,000 and $20,000. The total cost will depend on your chosen model and features and any home modifications required to accommodate the tub. Space may be a factor when deciding between a walk-in tub or a walk-in shower. Both walk-in showers and tubs can be customizable in size, but some walk-in shower models are designed to fit into the space of a standard bath and shower. Again, mobility needs, cost, and space should be considered, with the pros and cons weighed accordingly before purchasing any equipment.

Are there exceptions when Medicare might cover a walk-in tub?

In rare instances, Medicare may make exceptions, providing seniors reimbursement. However, Medicare will require specific information to determine on a case-by-case basis. A Medicare-approved physician must provide supporting documentation and medical records proving your medical condition and indicating why you need a walk-in tub.

Typically, Medicare only approves the basic model necessary to accommodate your situation. Additionally, Medicare will not provide reimbursement upfront, so you must initially shoulder the costs. There is no guarantee Medicare will cover all or part of the costs once they review your records.

Medicare may also make you sign a form accepting financial liability if they decide against covering a bathroom conversion. When working with Medicare on possible reimbursements, they are very strict about using Medicare-approved companies and may only consider applying benefits to specific models. So be aware of these stipulations if you are hoping for Medicare reimbursement, and contact your plan representative for more information.