Does Insurance Cover Walk in Tubs and What You Need to Know

Insurance coverage for walk-in tubs can be a bit of a mystery, but it's worth understanding what's covered and what's not. Some insurance policies may cover walk-in tubs, but it depends on the type of policy and the specific features of the tub.

If you have a Medicare Advantage plan, you may be eligible for coverage of walk-in tubs, but only if they are deemed medically necessary. For example, if you have a condition that makes it difficult to bathe safely, a walk-in tub may be covered.

The cost of a walk-in tub can be a significant factor in determining insurance coverage. On average, a walk-in tub can cost between $8,000 and $15,000, which may be a barrier to coverage for some insurance policies.

Medicare typically doesn't cover walk-in tubs, as they are considered "convenience" items rather than "medically necessary" equipment.

If you're eligible for Medicaid, your state's program might offer financial assistance for a walk-in bathtub, but this varies by state.

Medicare doesn't consider walk-in tubs to be durable medical equipment, which means it won't cover the cost of the tub or installation.

You should review your private insurance policy to see if it covers walk-in tubs, as coverage varies widely and depends on the specifics of your policy.

Some private health insurance or long-term care insurance policies may cover equipment or renovations that provide medical benefits or necessary home modifications, but this is not standard.

To determine if your private insurance policy covers walk-in tubs, speak directly with your insurance provider or review your plan carefully.

Medicare's main purpose is to cover costs related to diagnosis and treatment of health conditions, not modifications of homes like walk-in tub installation.

If you're eligible for both Medicare and Medicaid benefits, you might qualify for a Dual-Eligible Special Needs Plan, which is a type of Medicare Advantage plan that tailors its benefits for dual-eligibles.

Medicaid coverage for walk-in tubs can vary by state, but most states don't cover them. However, some states offer Home and Community Based Services (HCBS) waivers that might cover walk-in tub installations as a way to help beneficiaries live more independently.

Consulting with local Medicaid offices is the best way to understand if these provisions exist in your state and whether you qualify under the specific rules.

Medicare doesn't cover walk-in tubs as they're not considered medically necessary equipment or supplies.

Equipment and installation costs for walk-in tubs can be a significant investment, with prices ranging from $8,000 to $30,000 or more, depending on the features and size of the tub.

A walk-in tub typically requires a standard electrical outlet and a water supply line, which can be easily integrated into your existing bathroom plumbing.

The installation process usually takes around 2-5 days, depending on the complexity of the job and the number of professionals involved.

A licensed plumber or contractor is typically required for the installation, which can add to the overall cost but ensures a safe and proper installation.

Walk-in tubs are not considered durable medical equipment (DME) for Medicare coverage. This means that Medicare plans won't cover the cost of installing a walk-in tub.

Original Medicare and Medicare Supplement insurance plans view adding a walk-in tub as a home improvement, not a medical expense.

A walk-in tub can be a great investment, especially when you consider the cost of alternatives. The initial cost of a walk-in tub can be high, but it's still more cost-effective than moving to a senior living or assisted living facility, which can cost up to $60,000 or more every year.

There are ways to control the costs of your walk-in tub, such as financing options that make the purchase more manageable over time. You can also explore tax deductions, depending on your circumstances, you may be able to claim the expense of installing a walk-in tub as a medical deduction on your taxes.

Some non-profit organizations and government programs offer financial assistance for home modifications, including grants and programs aimed at seniors and individuals with disabilities.

Some Medicare Advantage plans may cover walk-in tubs, but it's not common. You'll need to contact your plan's carrier directly to ask about coverage for home safety modifications.

To get Medicare to reimburse for a walk-in tub, you'll need a medical prescription from a healthcare provider that explains why you need one. The prescription should include exactly why you need the tub and what features you need with it.

Medicare will only reimburse for the basic features of a walk-in tub, not the extra features like air jets or whirlpool features. It's essential to keep this in mind when picking out the tub.

Here are the steps to take if you want Medicare to reimburse for a walk-in tub:

In rare cases, Medicare will reimburse older adults for a walk-in bathtub, but only if you have a medical prescription from a healthcare provider.

To get the prescription, you need to explain exactly why you need the walk-in tub and what features you need with it. This prescription is crucial to get reimbursement.

Medicare will only reimburse for the features you need, not for the extra bells and whistles. For example, if you need a basic bathtub with a door, that's what Medicare will cover.

Medicare doesn't pay upfront for the tub, but rather compensates in the form of a reimbursement. However, reimbursement isn't guaranteed and there have been cases where Medicare denied reimbursement claims.

A prescription doesn't guarantee reimbursement, but failure to obtain one ensures that you won't receive reimbursement.

Medicare Advantage plans include extra benefits beyond those covered by Original Medicare, but coverage for walk-in tubs or showers is not common.

To find out if your plan covers walk-in tubs, you need to contact your plan's carrier directly and ask about coverage for home safety modifications.

Your doctor can document why a walk-in tub is medically necessary for your situation, but this is just one part of the process.

Here are the steps to follow: