[et_pb_section fb_built=”1″ _builder_version=”4.16″ locked=”off” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row custom_padding_last_edited=”on|phone” _builder_version=”4.16″ custom_padding=”||||false|false” custom_padding_tablet=”” custom_padding_phone=”||||false|false” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||” theme_builder_area=”post_content”][et_pb_text _builder_version=”4.16″ custom_padding=”||||false|false” text_line_height_tablet=”” text_line_height_phone=”” text_line_height_last_edited=”on|phone” ul_line_height_tablet=”” ul_line_height_phone=”2.5em” ul_line_height_last_edited=”on|phone” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n
Getting in and out of the bathtub, can, for elderly adults, present many difficulties and risks. And it isn’t hard to imagine all the accidents you could have. A great solution to these problems comes in the form of bath chairs and transfer benches.<\/p>\n
Medicare does not consider bath chairs as “medically necessary”, and so does not usually cover them.<\/strong><\/p>\n However, Medicare Advantage Plans, Medicaid, veterans benefits and other state funding sources do cover bathroom equipment that Medicare does not.<\/strong><\/p>\n [\/et_pb_text][et_pb_text _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n The fact that Medicare Part B does not usually cover bath and shower chairs, does not mean that it never will.<\/p>\n If you are to get coverage for a bath chair from Medicare Part B, you are going to need to get a prescription for it from a Medicare-enrolled physician, stating that it is “medically necessary”.<\/p>\n The physician is going to have to show and document how the bath chair is going to help with your diagnosed medical condition.<\/p>\n Even if you get the prescription, and all the relevant documentation, Medicare may still refuse coverage.<\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_toggle title=”Contents Overview & Quicklinks” open=”on” open_toggle_text_color=”#005bdb” icon_color=”#005bdb” _builder_version=”4.16″ _module_preset=”default” title_text_color=”#005bdb” body_ul_font=”||||||||” body_ul_text_color=”#59bdd6″ background_color=”rgba(190,229,247,0.47)” border_radii=”on|10px|10px|10px|10px” border_width_all=”2px” border_color_all=”#0b00ea” locked=”off” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n Does Medicare cover shower chairs ?<\/strong><\/a><\/p>\n Can a doctor prescribe a bath or shower chair ?<\/strong><\/a><\/p>\n Sample letter of medical necessity for a bath or shower chair<\/strong><\/a><\/p>\n Diagnosis\/guidelines for a bath or shower chair\u00a0<\/strong><\/a><\/p>\n Do Medicare Advantage Plans cover bath chairs ?<\/a><\/strong><\/p>\n Does Medicare cover bathroom equipment ?<\/strong><\/a><\/strong><\/a><\/strong><\/a><\/p>\n Will Medicare pay for bathroom modifications ?<\/strong><\/a><\/p>\n <\/a><\/strong><\/p>\n What equipment does Medicare pay for ?<\/strong><\/a><\/p>\n Medicare-approved medical equipment supplier near me ?<\/strong><\/a><\/strong><\/p>\n List of durable medical equipment typically covered by Medicare<\/strong><\/a><\/p>\n How do you get DME covered by Medicare Part B ?<\/strong><\/a><\/p>\n What do you do once you have a prescription for your DME ?<\/strong><\/a><\/p>\n What to avoid when purchasing DME with Medicare coverage ?<\/strong><\/a><\/p>\n What happens if you are in a skilled nursing facility ?<\/strong><\/a><\/p>\n Do Medicare Advantage Plans cover bath chairs ?<\/strong><\/a><\/p>\n Free assistance with understanding Medicare<\/strong><\/a><\/p>\n Does Medicaid cover bath\/shower chairs and bathroom equipment ?<\/a><\/strong><\/p>\n How to find the HCBS programs, waivers and 1915 waivers in your state ?<\/strong><\/a><\/strong><\/a><\/strong><\/strong><\/strong><\/a><\/p>\n What if your revenue is a bit too high to qualify for Medicaid ?<\/strong><\/a><\/p>\n What’s the procedure for getting DME\u00a0 with Medicaid and state waivers, and HCBS programs ?<\/a><\/strong><\/p>\n Non-Medicaid S<\/strong>tate Assistance<\/strong><\/a><\/p>\n How to get bath chairs and other DME covered as a Veteran ?<\/strong><\/a><\/p>\n Summary<\/strong><\/a><\/p>\n [\/et_pb_toggle][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text module_id=”medbathchairshower” _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n So, typically Medicare Part B does not cover shower chairs, but in some cases where it is proven to be medically necessary, a beneficiary may be covered for a shower or bath chair.<\/strong><\/p>\n [\/et_pb_text][et_pb_text module_id=”medbathchairprescribe” _builder_version=”4.16″ _module_preset=”default” locked=”off” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n Medicare Part C, or Advantage Plans, are different because they are run by privately contracted companies, who provide at least the same services as Original Medicare, and can provide some extra benefits which cover more items than Original Medicare. <\/p>\n There are many examples online of letters of medical necessity; you can see one here<\/a><\/strong>.<\/p>\n [\/et_pb_text][et_pb_text module_id=”medbathchairdiagnosis” _builder_version=”4.16″ _module_preset=”default” locked=”off” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n The Community Health Plan of Washington, has published outlines of the requirements of coverage for a Specialty bath\/shower chair, on their website.<\/p>\n You can read that here.<\/strong><\/a><\/p>\n In short, the recipient has to –<\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text module_id=”medbathchairadvantage” _builder_version=”4.16″ custom_padding=”||||false|false” text_line_height_tablet=”” text_line_height_phone=”” text_line_height_last_edited=”on|phone” ul_line_height_tablet=”” ul_line_height_phone=”2.5em” ul_line_height_last_edited=”on|phone” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n <\/p>\n If you have a Medicare Advantage plan <\/strong>(or Medicare Part C) you will have to check with your provider to see what extras are covered by their policy.<\/p>\n Medicare Advantage plan holders are legally entitled to the same DME’s as Original Medicare, but often have extra benefits such as hearing and visual under their plan.<\/p>\n In 2019\u00a0\u00a0the Centers for Medicare & Medicaid<\/strong> released plans to increase the coverage of Medicare Advantage and Part D –<\/strong><\/p>\n Beginning in 2019, Medicare Advantage plans can now offer supplemental benefits that are not covered under Medicare Parts A or B, if they diagnose, compensate for physical impairments, diminish the impact of injuries or health conditions, and\/or reduce avoidable emergency room utilization.<\/em><\/p>\n<\/blockquote>\n The source for this text is – “CMS finalizes Medicare Advantage and Part D payment and policy updates to maximize competition and coverage”\u00a0 April 1, 2019.\u00a0<\/strong>You can read the whole release on the CMS.gov website here<\/a><\/strong>.<\/p>\n Medicare Advantage were allowed to broaden coverage of equipment for individuals with chronic health conditions, and some Advantage plans may be offering coverage for certain types of bathroom equipment such as grab bars, safety frames, raised toilet seats, or even modifications.<\/p>\n So, take a good look at the different plans out there, as you may find one with the bathroom equipment you are looking for.<\/p>\n You must be aware, though, that your Advantage plan provider may require that any DME be purchased from a supplier in their network. If you don’t, you may be refused coverage.<\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text module_id=”medbathchairequip” _builder_version=”4.16″ locked=”off” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n <\/p>\n Medicare coverage extends to items which it sees as “medically necessary”, but not too safety items which it often considers as “convenience”<\/strong>,\u00a0 “comfort items”<\/strong>\u00a0 and as\u00a0“not primarily medical in nature”<\/strong>.<\/p>\n The terms above in parentheses from the Medicare statements of coverage, as a “reason for denial” of coverage.<\/p>\n To a large extent items that what we would see as safety equipment, and as helping the elderly to maintain their independence, is not covered by Original Medicare.<\/p>\n <\/p>\n The types of items not typically covered by Medicare Part B for use in the bathroom include –<\/strong><\/p>\n <\/p>\n <\/p>\n Fortunately, some medical equipment designed for those with mobility issues is covered by Medicare Part B for use in the home, with certain stipulations (it has been proven to be “medically necessary”, it is prescribed by a Medicare-enrolled physician, and it has been acquired from a Medicare-approved supplier), and can be used in the bathroom to help with avoiding falls –<\/strong><\/p>\n <\/p>\n <\/p>\n 3 in 1, or All in One, bedsides commodes may be used as a –<\/strong><\/p>\n <\/p>\n <\/p>\n Walkers which are waterproof can be used –<\/strong><\/p>\n <\/p>\n <\/p>\n Patient lifts<\/strong> which are mechanical, and not electrical, are covered for individuals who cannot leave their beds (there are strict guidelines) and can in a lot of cases be used to help a person wash themselves in a shower.<\/p>\n If you have a Medicare Advantage Plan, things may be a little different for you, as they are now allowed to add a few more benefits than previously.<\/p>\n To find out about the changes to Medicare Advantage, go to that section further along in this article here<\/strong><\/a>.<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text _builder_version=”4.16″ custom_padding=”||||false|false” text_line_height_tablet=”” text_line_height_phone=”” text_line_height_last_edited=”on|phone” ul_line_height_tablet=”” ul_line_height_phone=”2.5em” ul_line_height_last_edited=”on|phone” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n <\/p>\n To get in and out of the shower, my mom uses a walker instead of a grab bar<\/strong>. There are also waterproof walkers which can be used in the shower for help with standing.<\/p>\n Walkers can also be use for standing at sinks and counters<\/strong> for added stability, and in front of the mirror too.<\/p>\n If you, or a loved one, have with problems sitting on the toilet, you can use a walker to help you keep your balance while getting on and off the toilet seat.<\/strong><\/p>\n If you have a larger shower you may be able to put a 3 in 1 portable commode chair in it (only if it is waterproof though)<\/strong>, which gives you the same possibilities as a shower chair.<\/p>\n If you can’t fit the commode chair in the shower, we have often given my mom a sponge bath seated in the 3 in one commode chair<\/strong>, and that works very well – this was post hip replacement surgery, and we had extra help at home for a month.<\/p>\n The 3-in-1 portable commode can also be used as a raised toilet seat.<\/strong><\/p>\n I have an article –\u00a0\u00a0“Can a 3 in 1 commode be used as a shower chair ?”<\/strong><\/a>\u00a0– which outlines the use of commode chairs in the shower and also tells about the types that you can get which are especially for the shower<\/strong>, and some of which have multiple uses around the home, even as transport chairs.<\/p>\n If you want to find out about using a bedside commode over the toilet I have another article<\/strong> – “Can a bedside commode be used over a toilet ?”<\/strong><\/a> which outlines which types of bedside commodes can be used over a toilet, how to go about setting it up, how to use it, and why it is a probably the best option for the elderly as a raised toilet seat.<\/p>\n If you decide to go with the portable 3-in-1 commode chair, you will need to follow the proper process outlined below to get coverage from Medicare Part B.<\/p>\n However, if you qualify for Medicaid, state waivers, HCBS programs,<\/strong> other state funding or Veterans’ Benefits and pensions, you may wish to skip ahead to those, as you should be able to get a bath chair – just click here.<\/a><\/strong><\/p>\n <\/strong><\/p>\n If you are not sure which way to go, I have a long article with 54 safety tips, that I\u00a0 put together over the years caring for my mom and dad, so that we could make the bathroom a much safer place<\/strong>. There are both practical tips, and equipment you may wish to look at. You can find that article\u00a0here.<\/a><\/strong><\/p>\n If you are learning how to help your loved one wash,<\/strong> you should take a look at my article all about helping someone bathe safely, whilst helping them to keep their dignity, at the same here.\u00a0<\/strong><\/a><\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text module_id=”medbathchairmodifications” _builder_version=”4.16″ _module_preset=”default” custom_padding=”||||false|false” text_line_height_tablet=”” text_line_height_phone=”” text_line_height_last_edited=”on|phone” ul_line_height_tablet=”” ul_line_height_phone=”2.5em” ul_line_height_last_edited=”on|phone” locked=”off” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n <\/p>\n Typically, home modifications will not be covered by Medicare Part B.<\/strong><\/p>\n Medicare Part B typically only covers durable medical equipment for use in the home which it considers to be “medically necessary”<\/strong>, and bathroom<\/strong>\u00a0modifications as “not primarily medical in nature”.<\/strong><\/p>\n In rare instances Medicare will cover the cost of a bathroom modification i.e. walk in bathtubs, but not before “medical necessity” is proven.<\/p>\n To prove it,<\/strong> both\u00a0a\u00a0medical diagnosis documenting proof of need is required<\/strong>, and a signed prescription of “medical necessity” from a Medicare-enrolled physician which demonstrates –<\/strong><\/p>\n Medicare Part B also requires that it may be\u00a0 “reasonably expected” that the modification, will either help to maintain the patient’s condition, or result in improvement<\/strong>.<\/p>\n Even so, an individual who all the required documents, and a statement stating that the modification, will either improve or maintain, the condition of their health, is not guaranteed that Medicare will give the coverage.<\/strong><\/p>\n You will also have to pay for everything up front, and that hope that Medicare will agree and reimburse you for some costs.<\/p>\n But, Medicare Advantage Plans are allowed, since the fall of 2020, to offer new benefits for bathroom equipment, and modifications for policyholders where the need has been diagnosed as “medically necessary”.<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row custom_padding_last_edited=”on|phone” _builder_version=”4.16″ custom_padding=”||||false|false” custom_padding_tablet=”” custom_padding_phone=”||||false|false” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text module_id=”medbathchairtype” _builder_version=”4.16″ custom_padding=”||||false|false” text_line_height_tablet=”” text_line_height_phone=”” text_line_height_last_edited=”on|phone” ul_line_height_tablet=”” ul_line_height_phone=”2.5em” ul_line_height_last_edited=”on|phone” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n <\/p>\n Medicare Part B will cover certain durable medical equipment for use in the home if it is “medically necessary”.<\/p>\n Durable medical equipment is medical equipment for use in the home which is able to withstand a lot of repeated use over a long period of time.<\/p>\n <\/p>\n Typical examples of this type of equipment are –<\/p>\n <\/p>\n <\/p>\n This equipment is only covered in very specific cases, and the conditions and cases vary with each piece of equipment, but it is only ever covered when it is shown to be “medically necessary” in accordance with the Medicare guidelines.<\/p>\n Medicare Part B does not cover what it considers to be safety or comfort items like raised toilet seats, room heaters, air purifiers or grab bars.<\/p>\n Disposable medical supplies are almost always not covered as well.<\/p>\n <\/p>\n Examples of medical supplies which aren’t covered are –<\/p>\n <\/p>\n <\/p>\n For your item of durable equipment to qualify for Medicare Part B cover, it must first\u00a0 –<\/p>\n <\/p>\n <\/p>\n If a piece of equipment you are looking at doesn’t\u00a0 meet these criteria, you most likely won’t be able to get it covered by Medicare.<\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text module_id=”medbathchairfind” _builder_version=”4.16″ custom_padding=”||||false|false” text_line_height_tablet=”” text_line_height_phone=”” text_line_height_last_edited=”on|phone” ul_line_height_tablet=”” ul_line_height_phone=”2.5em” ul_line_height_last_edited=”on|phone” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n <\/p>\n If you are trying to<\/span> locate a Medicare supplier<\/span><\/strong>\u00a0in your area, you can use this link at Medicare.gov<\/a><\/strong><\/span><\/span><\/p>\nDoes Medicare cover shower chairs ?<\/h2>\n
\nThe rules for bath chairs and shower chairs for Medicare are identical.<\/strong><\/p>\nCan a doctor prescribe a bath or shower chair ?<\/h2>\n
\nIf a Medicare-enrolled doctor has diagnosed you with a medical condition, for which a bath or shower chair is “medically necessary”, and found that you would benefit from using one, they can prescribe a bath, or shower, chair.<\/strong><\/p>\n
\n [\/et_pb_text][et_pb_text module_id=”medbathchairletter” _builder_version=”4.16″ _module_preset=”default” locked=”off” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\nSample letter of medical necessity for a bath or shower chair<\/h2>\n
\nA letter of medical necessity is provided by your Medicare-enrolled physician and includes –<\/p>\n\n
Diagnosis\/guidelines for a bath or shower chair<\/h2>\n
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Do Medicare Advantage Plans cover bath chairs ?<\/h2>\n
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Does Medicare cover bathroom equipment ?<\/h2>\n
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So, how can you adapt ?<\/h3>\n
Will Medicare pay for bathroom modifications ?<\/h2>\n
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What equipment does Medicare pay for ?<\/h2>\n
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Medicare-approved medical equipment supplier near me ?<\/h2>\n