Monday, September 26, 2022

Will Medicare Pay For Bathroom Remodeling

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Although Original Medicare doesnt reimburse for most bathroom safety equipment, the following financing options may be available to help seniors pay for essential items and home modifications:

  • Medicaid: Low-income seniors may qualify for medical coverage under Medicaid. Program terms vary by state, but some Medicaid plans may provide coverage for bathroom safety equipment for enrollees with mobility issues. Rules regarding equipment type, brand and price may apply.
  • VA benefits: Federal veterans benefits include programs such as the VA Aid and Attendance program and Housebound benefits, which help disabled vets and their surviving spouses pay for care-related services and support. Several VA housing grants are also available to help veterans pay for accessibility-related home modifications. Qualified veterans can apply for assistance online or at their local VA benefits office.
  • Manufacturer financing: Seniors may be able to receive financing help directly through the manufacturer or seller. Qualified seniors can receive the equipment immediately and pay it off by making affordable monthly payments to the manufacturer or financing company.
  • Charitable organizations: Nonprofit organizations such as Rebuilding Together complete home modifications for eligible low-income seniors who need help making their houses more accessible. Services may include the installation of bathroom safety equipment, such as grab bars and shower seats.

Will Medicare Pay For Bathroom Modifications

There are many reasons why you might want to make bathroom modifications. You might have a wheelchair that makes it difficult to navigate your current bathroom. You might have difficulty standing in the shower. You might just need some more user-friendly fixtures.

Whatever the circumstance, if youâre facing a remodel, you probably want to know if thereâs any assistance you can get. Itâs a medically necessary change, after all.

Today, weâre looking at bathroom modifications and whether Medicare will cover some of the cost of making your bathroom more accessible.

If you have any other parts of your house you have questions about, check out our previous post on home modifications and Medicare.

Medicares Policy On Walk In Bathtubs

Unfortunately for most seniors, walk in bathtubs are not considered to be durable medical equipment by original Medicare. Thus, original Medicare will not pay for the cost of a walk-in tub nor will they contribute to the cost of installation.

Having said that, there may be rare situations in which original Medicare does provide financial assistance. When this occurs, the support comes as reimbursement, rather than in advance of the purchase. The tub would have to be considered an absolute medical necessity. The beneficiary would need a medical diagnosis that proves his/her need. In addition, a written prescription that outlines the reasons for which a walk in tub is necessary, as well as any features specific to a brand is required. Even with all this support, there is no guarantee of original Medicares assistance. When it comes to original Medicare, it is best to think of the tub as an out-of-pocket purchase, submit ones claim, and hope for the best. However, one should be financially prepared to pay the full cost, including installation. Or look for other sources of assistance.

  • Prevent, diagnose, or treat a disease or injury
  • Make up for physical injuries/weaknesses
  • Better the functional and/or psychological effect of physical/heath issues
  • Assist in reducing the need for emergency care.

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Does Medicare Cover Wheelchairs

Medicare Part B covers wheelchairs and power-operated vehicles for use in the home when a Medicare-enrolled physician

submits a written order stating that you have a medical need for a wheelchair or scooter for use in your home.

The information above comes from the Medicare Wheelchair and Scooter Benefit PDF.

Are Power Scooters Covered By Medicare

Handicap Bathroom Remodels &  Medicare/Medicaid

Scooters are covered as DME if they are prescribed for use in your home by a doctor. Medicare will also help pay for a power wheelchair if it is deemed medically necessary and you meet certain conditions.

A power wheelchair is essentially an electric wheelchair and is meant for people who dont have the strength or mobility to safely use a manual wheelchair or steer a scooter. In addition to a written prescription, you also have to go through a face-to-face examination before Medicare will help pay for a power wheelchair.

Medicare will only help pay for a power wheelchair if you:

  • Significantly struggle to move around your home
  • Cant safely use a cane or walker
  • Cant safely use a wheelchair
  • Dont have the strength to operate or steer a scooter
  • Go through a face-to-face exam with your doctor
  • Can safely use the power wheelchair in your home

Medicare will cover 80 percent of the cost for a scooter or power wheelchair. You will owe 20 percent after you have paid your deductible. Your doctor and supplier must both be enrolled in Medicare. Scooters and power wheelchairs are not covered if you need them only for use outside of your home.

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Will Medicare Help Pay For Walk

Even if they are prescribed by a physician, Medicare will not cover any home items like tubs and showers. Although, they may give partial reimbursement of the cost in some circumstances.

Even if it is covered by Medicare, it will still likely cost you some money as well. Thatâs something to keep in mind as you approach any bathroom remodeling, as costs can pile up quickly in a home improvement project.

Common Types Of Home Modifications For The Elderly

There are many different types of modifications that can be made to accommodate for aging challenges. While not comprehensive, the following list is included to give readers an idea of common changes.

  • Accessory Apartments both for the elderly and live-in caregivers
  • Climate Controls installing larger digital displays and / or remote controls
  • Computer Equipment large screen monitors and oversized keyboards
  • Easy Use Fixtures oversized light switches and levers replacing or installed over faucet knobs
  • Grab Bars and Rails in bathrooms and hallways assist persons in preventing falls and improving mobility
  • Lighting modifications within the home and around the property for increased visibility and security
  • Pull Out Shelves also referred to as roll-out, glide-out or slide-out shelves, these enable easy access to deeper spaces for clothing, food and other storage
  • Push Button Door Openers to automate the opening and closing of doors

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Enjoy A Better Bathing Experience Sooner

Youre on your way to a safer, more comfortable bathing experience. Contact the individual programs and departments to see if you may qualify to receive financial assistance for a walk-in tub. You can also contact your local KOHLER Authorized Dealer for more information at .

Schedule your free consultation today.

Which Home Upgrades And Improvements Are Covered By Medicare

SafetyTubs – Walk-in Baths

Aging is a double-edged sword. It opens up new adventures and freedoms as you step into retirement and have time to do things you didnât before, such as spending time with grandchildren, traveling, volunteering, and learning new crafts or trades.

Unfortunately, aging can also bring about a decline in health that can damper the plans youâve been anticipating. When this happens, it can become difficult or even impossible to do what youâve always done. Tasks you performed without even thinking, such as getting into and out of a bathtub, walking upstairs, standing on the step-stool to reach things, or just hearing the doorbell or telephone ring become difficult.

Modifying your home to help you accomplish everyday tasks that have become hard to handle might seem like an easy fix â and it can be if the improvements are financially obtainable. If the modifications you need are covered by Medicare, youâd be out 20% of the covered cost plus your deductible .

If the improvements arenât covered, it could cost you hundreds, or even thousands, of dollars.

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Bathroom Remodeling For Seniors

Some seniors prefer to live in their own homes instead of in retirement homes or assisted living facilities. They are attached to their homes and find them more comfortable. And, in some cases, seniors may not want to go to retirement or nursing homes as they find it embarrassing. Theyd much rather stick to the independent lifestyle.

It is often a great option for seniors to stay in their home. However, some parts of their home must be remodeled, modified, or even renovated for their safety. After all, you cant deny that aging can take a toll on our bodies!

Bathroom remodeling is essential for seniors and people with disabilities because it makes it easier and less risky to access and use the bathroom. A simple turning of a traditional tub and shower to a walk-in shower is already a big help. And adding bathroom chairs and grab bars is an innovation that most people with balance issues find extremely helpful.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Why Isnt It Covered

Unfortunately, Original Medicare does not consider walk-in bathtubs to be durable medical equipment and therefore will not cover their cost. This is because anyone can use a walk-in tub, unlike wheelchairs, hospital beds, nebulizers and more. Technically speaking, however, anyone could use their family members hospital bed or wheelchair.

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Money Follows The Person Programs

These are Medicaid programs specifically intended for persons who are currently living in a nursing home but who wish to return to living in a private home . These programs include support for home modifications that help the newly reintroduced individual to safely access the home. As of August 2022, 44 states and Washington, D.C., have Money Follows the Person Programs. It should be noted that very often these programs are given different names in each state. For example, the MFP program in West Virginia is called Take Me Home, West Virginia.

AL, AR, CA, CO, CT, DE, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, VA, VT, WA, WI, WV and D.C.

Will Medicare Pay For Health

Handicap Bathtubs Medicare

Most retirees want to age at home or around loved ones. In fact, 88% of Americans surveyed in a new study said they would prefer to receive any ongoing living assistance they need as they age at home or in a loved one’s home, according to the Associated Press-NORC Center for Public Affairs Research. However, aging in place may necessitate health-related home renovations, especially for those with mobility challenges or other health issues that make it difficult to navigate a typical household.

Making home improvements for a safer and more accessible environment can be costly, and you may wonder whether Medicare covers such expenses. Original Medicare coverage pays for hospital stays Medicare Part B, which has a deductible, covers doctor’s visits and other types of medical care. However, Medicare typically does not pay for home modifications.

Even without assistance from Medicare, though, you can find alternative free or low-cost options for common health-related renovations you may be considering as you age in place.

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Veterans Benefits And Walk In Tubs

It is difficult to make a blanket statement about the Department of Veterans Affairs policy of paying for a walk in tub, as well as the home modification costs to install the tub. It is perhaps more beneficial to consider individual programs offered by the VA.

TRICARE and CHAMPVA with these insurance programs, it would be difficult to receive assistance for a walk in tub, as they do not consider them to be durable medical equipment. TRICARE for Life and CHAMPVA for Life function much like Medicare Supplemental Insurance programs. If TRICARE and CHAMPVA will not pay, then it is unlikely TRICARE for Life and CHAMPVA for Life will pay either.

Home Modification Grants On a more positive note, there are several VA programs that provide assistance that can be used for the purchase and installation of a walk in tub or roll in shower. The VA offers 3 different grants for disabled veterans:

Of these, the HISA Grant is the most applicable to aging veterans as their disability need not be connected to their military service. In other words, veterans who require a roll in shower simply because of aging challenges may qualify under the HISA Grant. Please note that a roll in shower is different from a walk in tub and HISA Grants do not cover walk-in tubs.

Medicare May Purchase Or Rent Dme

Depending on the cost of an item, Medicare either purchases it outright or they rent it.

Generally, with all but the less important purchases, Medicare will rent equipment on a monthly basis from a DME supplier.

For the duration of the rental period as long as the DME is rented from a Medicare-enrolled participating supplier who accepts assignment, your parent will pay a monthly co-payment of 20% of the Medicare-approved rental price.

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Veterans Programs For Home Modifications

There are home modification assistance programs available to veterans from both the Veterans Administration and from unassociated, non-profit organizations that serve veterans. The VA provides multiple grants including SAH Grants, SHA Grants, and HISA Grants for this purpose. Also available are Veterans Directed Home and Community Based Services . This program provides veterans with financial assistance to help them remain living in their homes. It provides them with a certain amount of discretion to use those funds as they see fit. Making home modifications to accommodate for a disability would be an acceptable use of funds regardless owhetherot their disability was connected to their military service. Learn more about Veterans Directed programs. Veterans pensions, such as Aid & Attendance, offer one-time bonuses for unreimbursed medical expenses. Should a home modification be a medical necessity, veterans receiving a pension can receive a temporary increase in benefits to cover the cost. Finally, the national, non-profit organization Rebuilding Together offers home modification assistance both in the form of labor and some materials to U.S. veterans through its Heroes at Home Program.

Does Medicare Pay For Walk

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There are some situations where Original Medicare will provide financial assistance when you install a walk in shower for your senior, but the answer to the question, does medicare pay for a walk in shower, is generally no. However, you can get some assistance in certain situations.

This type of assistance typically comes in the form of a reimbursement and not an advance of purchase, meaning you would need to cover all the installation costs yourself and then look to Original Medicare for compensation.

In cases like these, the bath remodel must be an absolute necessity for your senior or Original Medicare might not provide compensation.

That could mean that a medical diagnosis needs to be performed to prove your seniors need for a walk-in shower. The shower brand and its features could also be examined to ensure it fits your seniors specific needs.

Even under these circumstances, its possible that Original Medicare wont provide financial assistance, so you should be prepared to pay the full cost of your bath to shower conversion. After an out-of-pocket purchase is made, you can submit the claim for a reimbursement and hope for the best.

Contact the appropriate government office for more information about how Medicare can help your specific situation.

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Determining What Modifications Are Needed

While it is possible and tempting for the non-professional to assess the modifications required to make a home both accessible and safe for the elderly, the use of a professional occupational therapist can be worth the additional effort and is sometimes paid for by Medicare. There are two major considerations. First, it is important to recognize that aging is a progression. Modifications to accommodate needs today might not be sufficient for needs two years in the future. Being able to project how ones needs will change is of critical importance if one hopes to make lifelong modifications in a single project.

Second, knowledge of assistive technologies is critical. There are many devices on the market today and, importantly, a flood of new options become available each year. To make the most cost-effective modifications, one needs to be aware of the full breadth of products on the market today, but also the tools that will be available in the near future.

Does Original Medicare Pay For Bathroom Equipment

While Original Medicare doesnt currently cover bathroom remodeling, Medicare Part B can help cover some services and items of durable medical equipment to be used in the home:

  • Medicare Part B will pay for an occupational therapist to evaluate a home and determine what kind of modifications are medically required for aging in place.
  • Part B will pay for a commode chair if you cannot safely use a regular toilet and a commode chair is ordered by your doctor. If the DME supplier of your bathroom chair accepts Medicare assignment, you will typically pay only 20% of the Medicare-approved amount for the cost of your commode chair, after you meet your annual Part B deductible.
  • Part B may also cover assistive technology devices that are part of your home modifications, as long that they are required for medical reasons and prescribed by a doctor.

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