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. It makes sense to want to know what is involved in a major project such as installing a walk in bathtub before delving into it. So, the question for this article is…
Does Medicare or Medicaid pay for walk in tubs? Medicare.com says the nationally funded Medicare programs (Part A and Part B) do not consider walk in bathtubs to be Durable Medical Equipment (DME) and do not cover their cost or installation. BUT – the your state funded Medicaid program may cover it – contact your local Medicaid office for more information.
Medicare’s Policy On Walk In Tubs
Sorry to say that Medicare does not consider walk in bathtubs 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 bathtub, 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). But since we’re talking about walk in bathtubs in this article I’ll how these supplemental benefits would impact your purchase of this item. 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.
Other Ways To Pay 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.
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.
5 Benefits Of A Walk In Tub
- For anyone that has a mobility issue, a walk in tub is a very easy solution to the problem. Whether you use a walker, a cane or a wheelchair, there are tubs that can accommodate your needs. Like the Ella Transfer60 tub that I found on Amazon – it is built so that a wheelchair bound person can get in and out of the tub easily.
- The walk in tubs today also have shower features. As an Occupational Therapist I would often recommend walk in tubs for some of my patients but back then, the shower features were not included. So, seeing these on today’s models is wonderful. It means that the investment into this product is really for both a tub and a shower!
- Falls are the #1 fear of most elderly and their caregivers. According to the CDC (Center for Disease Control) the average hospital cost for a fall injury is over $30,000. And the cost is not the most important factor because the truth of the matter is, falls result in over 800,000 hospitalizations and more than 27,000 deaths. When it comes to caring for an elderly parent, preventing falls should be the #1 priority. The use of a walk in tub greatly reduces that risk.
- Being independent is extremely important to everyone, especially the elderly. As a caregiver, it’s a very difficult task to balance safety with independence so using as many tools as possible to help you achieve both is beneficial. Shower aids, long handled reachers and walk in tubs are just a few of the products that you can use to not only help your senior parent be safe but to give them as much independence as possible.
- Most elderly are not able to reap the soothing benefits of soaking in a bathtub simply because they cannot (or are afraid to) get in and out of their tubs. A walk in tub can give them the benefits of hydrotherapy to help with their arthritis, circulation and all the typical joint pains and muscle aches that many older adults experience.
The one downside to consider with walk in tubs is that you have to sit in the tub before you begin filling it, so there will be a few minutes where you may feel cold and a few minutes to get the temperature just right.
The same will be true for getting out of the tub – you must wait until the water drains completely before you can step out.
One way you can combat this is to install a heat lamp above the walk in tub (in the ceiling). I remember a patient who was extremely frail and for her, taking showers was a bit of a nightmare because she was unable to get warm (even though the temperature in her home was normally 95 degrees). So, I asked her family to install a heat lamp in the ceiling over her shower and that finally gave her the ability to wash herself properly in comfort.
I would also recommend to make sure that the walk in tub you choose comes with a scald prevention valve so that there is little chance of severely hot water injuring your elderly parent’s frail skin. Read about the walk in tubs that we recommend.
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.
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.
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 bathtubs 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.
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.