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Does Medicare Or Medicaid Pay For A Walk-In Tub?

medicare and medicaid

Medicare generally does not cover walk-in tubs as they are considered “convenience” items. However, Medicaid might cover the cost under Home and Community Based Services (HCBS) waivers if the tub is deemed a medically necessary home modification..

If you are interested in getting a walk-in tub, you may be able to find financial assistance through your state or local government.

You can also contact the manufacturer of the walk-in tub to see if they offer any financing options.

When it comes to making home improvements to accommodate an elderly parent with mobility issues, many caregivers first want to know if the project can be covered by the Medicare program or by Medicaid.

They also want to know what the overall costs will be, both initial and ongoing. 

Medicare’s Policy On Walk-In Tubs

I am sorry to say that Medicare Part A and Part B does not consider walk-in tubs to be durable medical equipment so, they won’t pay for the purchase of a walk-in tub nor would they contribute anything to the cost of the tub or towards installation costs.

BUT – if you (or your physician) can demonstrate that this type of tub is an absolute medical necessity – Medicare may reimburse you after you’ve purchased and installed it. 

To do this you would need…

  • a diagnosis of a medical condition that warrants a walk-in tub
  • a written prescription by your physician describing you you need a walk-in tub which should also include any specific features such as “it must have grab bars” or “it must have an anti-slip floor”, etc.

Please know that even if you can prove a walk-in tub is an absolute necessity, Medicare may still deny you.

There is no guarantee that Medicare coverage will reimburse you.

Medicare Advantage May Pay For Walk-In Bathtubs

So, where it may be very difficult to get Medicare to pay for a walk-in tub, Medicare Advantage (MA)  is a different story. 

Because this is run by private insurance companies the rules will be different from one company to another so if you have MA please check with your company.

But all Medicare Advantage plans offer “health related supplemental benefits” which is loosely defined (hence the different interpretations by different insurance companies). 

Basically, if any one of the following criteria are met, MA plans may pay for your walk-in bathtub.

  • the walk-in tub should be used to prevent, diagnose or treat a disease or injury
  • it should make up for any physical injury and/or weakness
  • it should better the physical function of the user
  • it should provide psychological benefits to the user
  • it should help to reduce the need for emergency care

Medicare Advantage Plans That Cover Walk-In Tubs

As of 2023, there are a few Medicare Advantage plans that cover walk-in tubs. These plans are typically offered by private insurance companies and may have different coverage options, so it is important to compare plans before choosing one.

Some of the plans that cover walk-in tubs include:

  • UnitedHealthcare offers a variety of Medicare Advantage plans that cover walk-in tubs. The coverage amount may vary depending on the plan, but most plans will cover a portion of the cost of the tub and installation.
  • Aetna also offers a few Medicare Advantage plans that cover walk-in tubs. The coverage amount is similar to UnitedHealthcare, and most plans will cover a portion of the cost of the tub and installation.
  • Blue Cross Blue Shield offers a few Medicare Advantage plans that cover walk-in tubs. The coverage amount varies by plan, but most plans will cover a portion of the cost of the tub and installation.

Again, it’s important that you know that not all Medicare Advantage plans cover walk-in tubs. If you are interested in a plan that covers walk-in tubs, be sure to check with the plan before you enroll.

Medicaid’s Policy On Walk-In Tubs

Medicaid is a state run program (and there are several different Medicaid programs per state).  It is more likely to pay for a walk-in tub than Medicare. 

But again, each state will have it’s own specific rules and criteria.

So please contact your state Medicaid program office for details and information on their HCBS waivers and if they will pay for durable medical equipment (DME) and if they consider walk-in tubs as DME.

Here is a list of each state’s Medicaid services contact information.

Financial Assistance For Walk-In Tubs

  • The USDA (United States Department of Agriculture) helps elderly in low income rural areas with purchases of DME, including walk-in tubs.  You must meet specific criteria (which you can read about here) and if you qualify, you can apply for assistance.
  • Your state may have financial assistance programs that help their citizens pay for home modifications and safety improvements to aid in aging in place issues.  Click here for a list of these programs.
  • Individual home modification grants provided by a variety of organizations across the country such as The Travis Roy Foundation, Gary Sinise Foundation and many more.  Click here for a list of these.
  • If you are a veteran, your military service may qualify you for a HISA grant (Home Improvement And Structural Alterations grant) or for one of the individual VA aid programs offered by the Department of Veterans Affairs to help pay for the cost of the walk-in tub.

How Much Do Walk-In Tubs Really Cost?

The following video by Independent Home shows a time-lapse of how a walk-in tub is installed. 

This will help to give you an idea of the process and the work that is involved in removing the original bathtub and replacing it with your chosen product.

The average purchase price of a walk-in tub plus the installation ranges anywhere from $3,000 to $10,000 or maybe even more.

Like most anything else, the more add-ons you choose or if you install special models, the higher the price.

Another factor to consider is how easily the tub can be brought in and installed.

Normally, walk-in tubs are wider than standard tubs and this can pose a problem when trying to bring them in through a doorway.

So, costs can go up if the doorway has to be altered to accommodate the tub installation process.

The average cost of a walk-in tub purchase by itself ranges anywhere from $2,000 to $9,000.

Because of features like whirlpool jets, you may have to upgrade your electrical panel, incurring more costs.

The required plumbing or electrical upgrades can add another $3,000 – $5,000 to the cost.

For more convenience, some manufacturers sell their tubs as a package, with the cost of installation included.

Another consideration: while you can use a typical 40-gallon water heater when you have a walk-in tub, most manufacturers recommend upgrading to at least a 50-gallon water heater.

The reason for this is that the average user who wants to fill their tub full enough to use the whirlpool jets will need between 40 and 50 gallons of water to do so.

Are Walk-In Tubs Tax Deductible?

According to the IRS publication 502, medical expenses are “the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness. They don’t include expenses that are merely beneficial to general health.”

So, basically, the IRS is saying that the walk-in tub has to be considered a medical expense and documentation has to show that this product is being used for the purpose of either preventing a physical problem (like a fall) or helping an existing problem like the inability to stand.

In general, the expenses for home modifications for a medical diagnosis may be eligible for tax deductions.

Is It Worth It To Purchase A Walk-In Tub?

It can be very difficult to make the decision to spend possibly thousands of dollars on a home modification if you’re not 100% sure that it’s worth it.

Frankly, what I found in the process of caring for my elderly mother at her home was that there are going to be some expenses made that, in the end, did not live up to our expectations. 

So, I say to you to simply do your research and make the best possible decision you can in the moment and don’t regret it.

Of course, that’s easier to say if you have the extra cash needed to pay for luxuries such as a walk-in tub or stair lifts for two-story homes.

But, if you take the cost out of the equation (if you can) and think about the benefits that a walk-in tub can give you and your elderly parent, then it may make more sense to you.

How Fast Does A Walk-In Tub Fill?

Another cost factor to consider when deciding whether or not to purchase a walk-in tub is the amount of water that it takes to fill it up.

This type of tub uses significantly more water than a traditional bathtub.

Walk-in tubs generally take anywhere from 6 minutes to 15 minutes to fill up.

Most walk-in tubs need 40 to 80 gallons of water to fill up. That means bringing the water up to chest level while sitting. In contrast, standard bathtubs take 25 to 45 gallons of water.

The average cost of water in the USA is about $1.50 per 1,000 gallons.

So, if you took 12 baths a month and your tub took 80 gallons of water each time you filled it up, then it would only cost you $1.50 for those 12 relaxing baths.

It’s a factor to consider when choosing the size of the tub. The more water, the higher your water bill will be. So choose carefully.

Naturally, the best alternative depends on the individual’s specific needs, mobility level, and personal preferences. It’s also important to consider the cost, installation requirements, and potential home value impact of each option.

Frequently Asked Questions

Does Medicaid Cover Bathroom Equipment?

The guidelines for Medicaid are different in every state but generally Medicaid will pay for DME (Durable Medical Equipment) that is medically necessary. This does not necessarily cover grab bars and walk-in tubs. But again, check with your state’s Medicaid program.

Does Medicaid Pay For Home Modifications?

Medicaid differs from state to state. But, most states do pay for home modifications for the elderly and/or disabled for the purpose of them being able to remain in their living environments. These programs within Medicaid are referred to as Waivers. Contact your local Medicaid office for information in your state.

What is an alternative to a walk-in tub?

A viable alternative to a walk-in tub is a roll-in shower. Roll-in showers offer easy accessibility with a level entry, eliminating the need to step over a tub wall. These showers are designed to accommodate individuals with mobility challenges, featuring spacious interiors, grab bars, and built-in seating. They are particularly beneficial for wheelchair users as they allow seamless movement within the shower area. Roll-in showers can be customized with various features like handheld showerheads, non-slip flooring, and adjustable water controls, providing a safe and convenient bathing experience.

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