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

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medicare and medicaid

According to Medicare.com – the nationally funded Medicare program (Part A and Part B) do not consider walk-in bathtubs to be categorized as Durable Medical Equipment (DME) so they do not cover the cost or installation of a walk-in tub. BUT – the state funded Medicaid program in your particular state might cover it.

When it comes to making home renovations to accommodate an elderly parent, many caregivers first want to know if the project can be covered by Medicare or Medicaid and what are the overall costs, initial and ongoing.  So, the question for this article is…

Medicare’s Policy On Walk-In Tubs

Sorry to say that Medicare does not consider walk-in tubs to be durable medical equipment so, they won’t pay for the tub nor would they contribute anything to the cost of the tub or installation.

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 medical diagnosis 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 have all of these, Medicare may still deny you.  There is no guarantee that they 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 MA insurance 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 – your Medicare Advantage insurance may pay for your 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

Again, please check with the insurance company that you purchased your MA from for specific details.

Medicaid’s Policy On Walk-In Tubs

Medicaid is a state run program (and there are several 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 criteria so please contact your state’s Medicaid 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 contact information.

Financial Assistance For Walk-In Tubs

  • The USDA (U.S. 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 here.
  • Your state may have programs that help their citizens pay for home modifications to aid in aging in place issues.  Click here for a list of these programs.
  • Individual 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 you may qualify for one of the individual programs offered by the VA to help you pay for a 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 cost 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, 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 installation process. The cost of the tub 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 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 medical purposes are 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.

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 for 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.

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. Click here for contact information for 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.

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