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Medicare and Bathroom Equipment

Specialized bathroom equipment may be necessary for you to avoid injuries and slips. It has been estimated that a large percentage of seniors above the age of 65 years experience serious injuries due to slips and falls in the bathroom every year.

The causes for the same could be diminished vision, balance issues, and muscle weakness.  Hence, it is advisable to install safety equipment in your bathroom to minimize the risk of such accidents. If you are planning to install safety equipment in your bathroom, read on to find if they are covered by Medicare.

bathroom equipment for disabled person

Does Medicare cover bathroom equipment?

Medicare Part B offers coverage for some Durable Medical Equipment (DME) that are considered medically necessary in order to prevent injuries. Bathroom safety accessories are usually recommended to increase the balance and stability of a person while walking. It may include support devices such as canes, walkers, and commode chairs.

However, not all the costs related to bathroom equipment is covered by Medicare. You may need additional coverage to receive reimbursement for all the expenses related to the purchase and installation of bathroom equipment.

You need to pay 20% of the cost of the equipment approved by Medicare. The Part B deductible for DME applies to all bathroom equipment that is recommended as medically necessary by a doctor.

Durable Medical Equipment must be prescribed by a registered healthcare physician and meet the following criteria for it to be covered by Medicare:

  • Must be medically necessary for preventing potential health hazards or supporting the recovery of the patient
  • It must be able to withstand long-term and repeated use
  • Must be of use in the bathroom
  • Is not useful to someone who is not injured or sick

The examples of bathroom equipment that may be medically necessary to ensure the safety of the patient include grab bars, transfer benches, non-slip mats for bathroom floor, tubs and shower, shower chairs, and raised toilet seats.

Medicare may cover the costs of this equipment to some extent when they are recommended by the doctor. Your Medicare part B may also cover other bathroom equipment like toilet safety frames, handheld shower heads, portable commodes, walk-in bathtubs, and emergency alert system.

There are different ways by which Medicare covers bathroom equipment. It may offer coverage only for the cost of renting the equipment or in some cases, cover the cost of purchase.

In both cases, the doctor and the supplier should be enrolled in Medicare as service providers. Stringent guidelines are in place to ensure enrollment of both the doctors and supplier of DME before providing coverage as there is a risk of the supplier charging the patient a higher amount. If your doctor or the supplier does not participate in Medicare, the full cost of the bathroom equipment will have to be borne by the patient.

Hence, patients must check with the physician as well as the supplier to confirm both are enrolled and participate in Medicare.

You can also opt for a Medigap plan for additional insurance to manage the costs of bathroom equipment not covered by Medicare Part B. Medicare Advantage Plans also provide coverage for bathroom equipment.

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