Will Medicare Pay For Your Bathroom?
In short, no. However there is much more to this story. Original Medicare typically does not cover walk-in tubs or bathroom remodels as they are not classified as durable medical equipment. However, other coverages may be of help here. There are some instances where you can seek reimbursement if the tub is deemed a medical necessity in Medicare Plan B or Medicare Advantage plans. This requires a prescription and a letter of recommendation from your doctor, detailing why the tub is necessary for your health and safety.
Medicare’s Stance on Walk-In Tubs
If Medicare is going to provide you with a reimbursement, it is a reimbursement. This means you must purchase the tub first and have a paid invoice to submit to them. After you have collected that and varies other documents then you may submit for their assistance. In order to be reimbursed for the walk-in tub, it must be considered a medical necessity by a licensed professional. You must have a prescription from your doctor that showcases why this is a necessary item/project. This prescription should also include any features that may be needed to help remedy your diagnoses, this could include jets, specific shower heads, seating arrangements, amongst other things.
How To Get Medicare To Reimburse You For Your Bathroom:
- Secure a Prescription: Visit your doctor to get a prescription for the walk-in tub.
- Obtain a Letter of Recommendation: This should outline your medical condition and how the tub will benefit your health.
- Purchase and Install the Tub: Keep all receipts and documentation.
- Complete the Paperwork: Fill out Medicare Form CMS-1490S if you are enrolled in Medicare Part B. Or any other necessary paperwork relevant to your specific coverage.
- Gather Your Forms: Include the form, prescription, recommendation letter, model specification, invoice, and any other documents that may be helpful in stating your case.
- Submit Your Claim: You are ready to mail in your claim!
Other Financial Assistance Options:
Medicare Advantage Plans: Some plans may cover the cost if the tub is used for medical purposes.
Medicaid: State Medicaid programs might provide assistance for durable medical equipment or home modifications.
Veterans Benefits: Various VA programs, like VD-HCBS and VA Aid and Attendance, offer grants or flexible budgets that could cover walk-in tubs.
Tax Deductions: If the tub is for safety reasons, it may be tax-deductible as a medical expense.
For more detailed guidance and assistance, refer to your local Medicare or Medicaid office, or consult with a VA representative if you are a veteran.
While this is a guide to help you understand Medicare’s policies on paying for walk-in tubs, this is not legal advice. As always you should seek additional guidance and assistance from your local Medicare office to learn more about your specific situation.
