Wednesday, June 7, 2023

Is A Walk In Tub Covered By Medicare

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What About Medicare Part B Covering Walk

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Medicare Part B will cover walk-in tubs if they are considered to be durable medical equipment, and in some cases, they are. If you can prove that the walk-in tub goes above and beyond comfort and convenience measures, you might be able to get Medicare to foot the bill for your tub.

A medical diagnosis from your doctor that supports your need for the walk-in tub as medically necessary will be required. In most cases, your doctor will submit a medical report on your behalf to the insurance company or, at the very least, will write you a prescription for the tub.

Gathering the appropriate documentation and proofs before submitting a claim to Medicare Part B does not ensure you’ll get approval, but it does increase your chances.Columbus Walk-in Bath Solutions is a company that cares about the well-being of its clients. Helping people get the walk-in tub and shower that helps them perform daily hygiene activities is what the company does best. If Medicare doesn’t cover the cost of the tub, you can count on the company to offer budget-friendly prices and flexible financing options to make paying for the tub much easier.

State Assistive Technology Programs

All states across the US have what is called a State Assistive Technology Program, which is funded by a national grant.

The AT Programs were set up to improve access to assistive devices in the home, primarily for the elderly and the disabled.

Your State Assistive Technology Program should have the following services

  • an online equipment exchange which state residents can just register on and participate in
  • a main website giving all the relevant information on their services, events, projects, and also acting as a hub for the contact with the community of eligible individuals
  • refurbishment, recycling and reuse programs and centers to provide free, or extremely low cost, equipment for the disabled and the elderly
  • loan closets

Your Assistive Technology Programs will contact individuals in need when specific equipment becomes available.

Look up your State Assistive Technology Program website to find out more.

To see what projects are in your state click here.

Does Medicaid Pay For Walk

Some Medicaid programs may offer assistance for environmental accessibility modifications. That is modifications to your home to improve your accessibility. While your purchase of a walk-in tub may not be covered entirely, it is possible to receive some financial assistance. Home and community-based services may provide you with additional assistance or services to meet your needs. You might not be able to get a walk-in tub paid for, but you may be able to get an alternative covered. Finally, dont forget to look into financial assistance programs to help cover costs. And low-interest financing can help you cover expenses on your own.

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Does Medicare Pay Walk In Tubs

A plethora of different medical items belong to the group which is considered as durable equipment.

Medicare program usually reimbursement for the following items:

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  • Specially designed adjustable bed which is of hospital-style
  • Special chairs
  • Patient lift
  • Special commodes

In fact, all these pieces are in place so that seniors can use a walk in tub shower easily and safety.

Getting The Best Price On A Walk

Does Medicare Pay For Walk in Tubs [Complete Guide ...

Chicago based manufacturer of acrylic walk-in bathtubs Ellas Bubbles is proud to announce the availability of an incredible array of best-in-class walk-in tubs at the most competitive prices in the nation. Budget-minded homeowners are now given the opportunity to make it easier for their family members, including their aging parents to enjoy a more comfortable, therapeutic, and safer bathing experiences in the comfort of their own home.

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Customers Of Ellas Bubbles Frequently Ask If Medicaid Will Pay For A Walk

Although Medicare expanded supplemental benefits in 2018, Medicaid is still the more likely of the two programs to cover the costs of purchasing and installing a walk-in bathtub. Financial assistance, however, is by no means guaranteed.

Medicaid is fundamentally different from Medicare. While Medicare Part A and Part B are single programs administered by the Federal Government, Medicaid is managed on the state level. Furthermore, each state has multiple Medicaid programs. There are literally hundreds of Medicaid programs out there, each with its own set of rules.

Which programs you are eligible for depends on your state of residence and a number of other factors. For example, under the umbrella of Medi-Cal are separate programs for infants, pregnant women, assisted living, and nursing home care, none of which offer assistance in purchasing walk-in bathtubs.

Broadly speaking, Medicaids offers financial assistance for durable medical equipment. Unfortunately, walk-in tubs termed low-threshold showers under program rules are not usually recognized as durable medical equipment. The language is vague to allow for new technology, but the burden of interpretation is in the hands of Medicaid administrators. Historically, walk-in tubs have not usually made the cut.

A list of applicable waivers can be found at this website:

Va Aid And Attendance Housebound And Other Pensions

These pensions offer greater freedom to decide how the allowance is spent. With the only stipulation that it be used for the care of the beneficiary, a walk-in tub is an appropriate expense. The cost of a walk-in tub can also be considered an unreimbursed medical expense, which means it can be deducted from a veterans income. In turn, the veterans pension benefit will increase in the amount of the deduction, essentially covering the cost of the tub.

To learn more about veterans benefits, please contact your regional VA office or check out our blog.

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Other Ways To Cover The Expenses Of Getting A Walk

Even if you cant get help from Medicare, you may be able to offset costs in a few ways. First, your tub installation is likely tax-deductible, especially if you can prove that it was installed for medical necessity. In this case, you can make the deduction through the medical expense deduction.

If you live with an adult child or other caretaker, the person who owns your home may be able to deduct the expense on their taxes. This is done through the Dependent Care Tax credit. Depending on your state, additional deductions or credits may be possible. Be sure to speak with your tax advisor about your options.

In addition to a tax credit, you can also consider payment plans to help you spread the cost of installation over many months. You can speak with your supplier about financing options. Just be sure to choose a monthly payment that fits your budget.

The Spend Down Program

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Spend-Down programs were devised as a method for reducing a persons income, or income + asset level, so that they may become eligible for Medicaid coverage.

To find out more about Spend Down you need to take a look at my article where I outline who can qualify for Spend Down, the expenses that you can deduct, and how you know if you qualify What is Spend Down ?

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Other Factors That Affect Coverage

How much a person will pay for DME depends on:

  • other policies a person may have
  • type of equipment
  • how much the doctor charges
  • if the doctor and supplier accept Medicare assignment

If a persons doctor and the DME supplier are enrolled in the Medicare program, it means they will accept payment directly from Medicare, and costs are regulated.

For example, Medicare pays 80% of the approved amount, while a person pays 20% after paying the standard Part B deductible of $203 per month in 2020, provided that a persons income is $87,000 or less. However, if the doctor or supplier is not enrolled in Medicare, a person may have to pay 100% of the cost.

Similarly, if a person is buying DME, they should check if the supplier participates in Medicare, which means the supplier will charge only 20% coinsurance and any remaining deductible for Part B. If the supplier does not participate in Medicare, they can charge higher costs.

What Is A Walk

For those who may have trouble with balance or mobility issues, it can be difficult to step over the edge of a high bathtub into hot water without risking injury. A walk-in tub has been modified so you no longer have to worry about this issue! They also come equipped with safety features such as seats which allow you take advantage of all their benefits while keeping yourself safe at all times.

If you are a disabled veteran check out this article.

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Does Medicare Cover Raised Toilet Seats

Raised toilet seats are something Medicare considers a convenience item. However, some Advantage plans find this supply medical, especially in cases where a patient is unable to bathe without being seated if a patient is unable to transfer in and out of the tub.

Anyone can buy a toilet seat with arms and elevation online, sometimes with same-day delivery. Medicare doesnt cover toilet seat risers but, many of them are affordable.

Is There Financing Available For A Walk

Requirements for Medicare Coverage of Walk

Given these alarming statistics, walk-in tubs are no longer a luxury they are an absolute necessity for people who want to remain and age in their own home independantly. However, these walk-in tubs may not be financially accessible to all of those who need them. So is there financing available for a walk-in tub? The answer is yes, there are several financing options one can consider when looking for a walk-in tub.

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Coverage Through A Medicare Advantage Plan

Medicare Advantage is an alternative to original Medicare where you choose a private insurance company to provide your Medicare benefits.

Medicare Advantage companies can offer additional benefits that extend beyond traditional Medicare offerings. These may include:

  • transportation to medical appointments
  • even home air filters for those with asthma

Its possible that some Medicare Advantage plans may extend those benefits to include coverage for a walk-in tub.

Thousands of Medicare Advantage plans exist. Theyre subject to regional, company, and Medicare rules.

So, its best to contact your Medicare Advantage company directly to ask about potential coverage or reimbursement. If youre shopping around for plans, you can ask about this coverage in advance and request an answer in writing before purchasing a plan.

If your plan does cover a walk-in tub, its likely you would follow protocols similar to those of original Medicare: Your doctor would need to write a prescription for the tub, and youd need to choose a supplier that accepts your plan and is in network.

What Might A Walk

Costs of walk-in bathtubs may vary widely from one company to another. While Medicare doesnt typically cover walk-in bathtubs, if you get both Medicare and Medicaid benefits, you might qualify for a Dual-Eligible Special Needs Plan. This is a type of Medicare Advantage plan that tailors its benefits for beneficiaries who are eligible for both Medicare and Medicaid coverage, also known as dual-eligibles.

To find out if your state Medicaid program might help pay for a walk-in bathtub, contact your states State Health Insurance Assistance SHIP Program.

Would you like to see if theres a Medicare plan option in your area that might fit your health-care needs? Im happy to walk you through your options or email you information you can request that using the links below. Or take a look at plans by clicking the Compare Plans buttons on this page.

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Becoming eligible for Medicare can be daunting. But don’t worry, we’re here to help you understand Medicare in 15 minutes or less.

New To Medicare?

Becoming eligible for Medicare can be daunting. But don’t worry, we’re here to help you understand Medicare in 15 minutes or less.

Find affordable Medicare plans in your area

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What Safety Equipment Does Medicare Cover For The Bath

Original Medicare will likely cover shower chairs to help make your bath safer. However, other bathroom safety equipment, like grab bars, anti-slip mats, and special showerheads, is often not covered by Original Medicare. Some of this equipment may be covered under a Medicare Advantage plan. Be sure to speak with your health care provider about your options. Lastly, some home modifications can be tax-deductible as medical equipment.

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As there is no guarantee that you will be successful, if they deny your request, your only loss will be the cost of envelopes, photocopying, and postage. Bathing is a vital part of maintaining health. If more older adults request consideration to get reimbursements, Medicare may change their practice.

However, after you are done with the purchase of your walk-in tub, submit your doctor’s prescription, as well as the paid invoice for the tub to Medicare. Medicare does reimburse a portion of your purchase price rarely, so it does make sense to look for partial reimbursement.

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Collection And Use Of Medicare Information

We are authorized by the Centers for Medicare & Medicaid Services to ask you for information needed in the administration of the Medicare program. Authority to collect information is in section 205, 1872 and 1875 of the Social Security Act, as amended.

The information we obtain to complete your Medicare claim is used to identify you and to determine your eligibility. It is also used to decide if the services and supplies you received are covered by Medicare and to ensure that proper payment is made.

The information may also be given to other providers of services, carriers, intermediaries, medical review boards, and other organizations as necessary to administer the Medicare program. For example, it may be necessary to disclose information to a hospital or doctor about the Medicare benefits you have used.

With one exception, which is discussed below, there are no penalties under Social Security law for refusing to supply information. However, failure to furnish information regarding the medical services rendered or the amount charged would prevent payment of the claim.

Failure to furnish any other information, such as name or claim number, would delay payment of the claim.

It is mandatory that you tell us if you are being treated for a work related injury so we can determine whether workers compensation will pay for the treatment. Section 1877 of the Social Security Act provides criminal penalties for withholding this information.

Subsidies For Seniors Or Handicapped

The US Department of Agriculture offers a grant to seniors living on a low income in rural areas. Seniors can apply to use this grant to cover home modifications, including the cost of a walk-in tub.

The best way to start the application process is to contact your local USDA service center. You can find a map of service centers in each state here.

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Medicaids Policy On Walk In Tubs

Even with Medicare Advantage plans offering supplemental healthcare and new supplemental non-healthcare benefits, Medicaid is more likely to provide financial assistance for the purchase and installation of a walk in tub. Medicaid is not a single federal program. Instead each state has several different Medicaid programs. Therefore, there are possibly 100s of different sets of rules governing Medicaids policy on the purchase of a walk in tub or low threshold shower. For example, Medicaid in California has programs for pregnant women, infants, nursing home care, and assisted living. None of these Medi-Cal programs will pay for a walk in tub. However, the state had a Medicaid program called Community Transitions that helped nursing home residents move back to private homes. This program, which ended in January 2019 due to lack of funding, very likely would have covered the cost of a walk in tub. That said, the program may resume in the future if funds become available.

There are also Medicaid programs for Home and Community Based Services . For example, Colorado has an Elderly, Blind and Disabled Persons Waiver. This will pay for specialized medical equipment and environmental accessibility modifications. Under these guidelines, when medically necessary to help an individual remain living in their home, Medicaid will pay the purchase price and installation costs for a walk in tub.

Does Medicare Cover Walk In Bathtubs

Does Medicare Cover Walk

by Gareth Williams

For our elderly parents, stepping in and out of a bathtub can present great difficulties and risk, even if they are in relatively good shape. For many, the ideal solution is going to be a walk in bathtub, where there is at least little to no risk of tripping over. But the same cannot be said for the cost, which can also leave you feeling wounded !

Does Medicare cover walk in bathtubs ? Original Medicare does not, as a rule, cover walk in bathtubs. However, Medicaid, Veterans Benefits, rural funding, state waivers and non-medicaid state financial assistance plans for the elderly can cover bathroom equipment and remodeling.

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Durable Medical Equipment Definition

When it comes to Medicare and whether it will cover the cost of a given piece of equipment, such as a walk-in bathtub or many other potential types, the language to consider is whether the piece is considered durable medical equipment. These definitions stem from the original version of Medicare, one thats still followed in several important ways.

Unfortunately, in most cases walk-in bathtubs are not considered durable medical equipment under original Medicare. This means original Medicare will not pay for their cost or their installation. However, this does not mean there is no chance for Medicare financial assistance for a walk-in tub, as well detail below.

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