Walk in Tubs Coverage By Medicaid and Medicare

There’s a lot to consider when you’re researching walk in tubs – who knew there’d be so many options and add-ons? But to make an informed decision, you need to have a basic understanding of all the options and implications.

However, the main question we get from home owners who want to add a walk in tub to their home is the Medicare & Medicaid Coverage of Walk-in Tubs.

1) Medicaid

Generally, Medicaid is considered more likely to offer financial assistance with your walk-in tub. However, similarly to Medicare, walk in tubs remain in a gray area, meaning that successful claims will be on a case-by-case basis, depending on your state.

Because walk-in tubs could be considered ‘Specialized Medical Equipment’ or an ‘environmental accessibility modification’ to your home, which are covered by Medicaid, there is more room for Medicaid to consider your application.

Follow the same procedure as you would in your Medicare claim, but remember: You may not receive any reimbursement, and have to be able to cover the full cost.

2) Medicare

Although Part B of Original Medicare covers ‘durable medical equipment’, this does not include walk-in tubs. However, there are two possible ways around this specification.

a) Reimbursement
Medicare may reimburse some of the cost for individuals who have an ‘absolute medical necessity’ to use a walk in bath tub. In case you are one of these few exceptions, we strongly recommend obtaining a prescription for a walk in tub from your doctor before purchasing your tub. With a clear outline of the reasons why you require a personal walk in tub, Medicare may consider reimbursing some of your costs if you claim at a later date. But make sure the date of your prescription precedes the date of your walk-in tub invoice. You must be willing to pay the full price in case Medicare rejects your claim.

b) Dual Eligible Special Needs Plan.
If you are eligible to claim both Medicare and Medicaid, you are considered a ‘dual eligible’. A local SNP (Special Needs Plan) may be able to advise you on how to use your plan to claim some of the costs of your walk in tub.

Many walk in tub jobs end up being a full Remodeling Jobs for the bathroom. When the job requires the remodeling (due to pipeline positions usually), the Job cost may increase and Medicare & Medicaid may not cover it fully.