When it comes to growing older, maintaining your independence and safety can often hinge upon your surroundings. It’s a stark reality that accidents in the home, especially in the bathroom, account for a significant number of injuries among seniors. As such, equipping your bathroom with the right safety gear can mean the difference between self-reliance and needing assistance. But does Medicare cover bathroom safety equipment? Keep reading to discover what bathroom safety equipment Medicare covers, the different parts of Medicare and how they apply to bathroom modifications, and how you can get the most from your coverage.
What is Bathroom Safety Equipment?
Before we dive into the coverage specifics, let’s discuss the essentials: what exactly do we mean by bathroom safety equipment? In general, this refers to the range of products and modifications designed to make your bathroom safer and more accessible. Commonly used bathroom safety equipment includes raised toilet seats, shower chairs, grab bars, commode chairs, walk-in tubs, and transfer benches.
These bathroom modifications can reduce the risk of slips, falls, and other injuries, particularly for those with limited mobility or balance issues. Even seemingly minor additions like grab bars or raised toilet seats can make a significant difference in personal safety. So, how does Medicare play into this? Let’s explore the most popular bathroom safety equipment in more detail including whether Medicare provides coverage or not.
Raised Toilet Seats
When you have difficulty sitting down or standing up from a standard-height toilet, a raised toilet seat might be a great solution for you. This piece of bathroom equipment is designed to increase the height of your existing toilet, reducing the distance you need to bend or squat.
Raised toilet seats come in a variety of designs. Some simply fit onto the top of your existing toilet seat, while others replace your toilet seat entirely. There are also raised toilet seats equipped with arms or handles, providing extra support when you’re lowering yourself or standing up.
Using a raised toilet seat could help you if you have conditions like arthritis, hip or knee problems, or other mobility issues. By reducing the need for excessive bending, you can maintain balance, minimize strain, and avoid potential discomfort or injury.
If you’re considering a raised toilet seat, it’s important to measure your existing toilet to ensure a good fit. The two main types of toilets, round and elongated, require different shapes of raised seats. Moreover, the height you need will depend on your own height and mobility needs.
While a raised toilet seat can be crucial to your safety and comfort in the bathroom, it’s important to note that Medicare doesn’t cover them. Medicare generally sees raised toilet seats as “convenience items” rather than durable medical equipment. However, some Medicare Advantage Plans may offer coverage and consider raised toiled seats a medical necessity.
Even without insurance coverage, raised toilet seats are often quite affordable, and investing in one could greatly enhance your safety and independence in the bathroom.
If standing for the duration of a shower is challenging for you due to issues with balance, weakness, or fatigue, a shower chair could be a significant help. This piece of equipment is designed to provide you with a secure and comfortable place to sit while you shower, allowing you to maintain your personal hygiene safely.
Shower chairs are typically designed to be waterproof and feature non-slip feet for stability. They come in a variety of designs. Some have backs and arms for added support, while others are more basic and only include a seat.
When choosing a shower chair, it’s crucial to consider the size of your shower or bath, as you want to ensure the chair fits comfortably and securely. Look for models that are adjustable, so you can set the height to what’s most comfortable and safe for you.
Ease of cleaning is another factor to consider. Shower chairs need to be cleaned regularly to prevent the buildup of soap residue or mold. A chair with a smooth, waterproof material will generally be easier to keep clean.
Shower chairs, although sometimes seen as a luxury or convenience item, can indeed be a necessity if you have difficulty standing or balancing. Medicare doesn’t cover shower chairs, but some Medicare Advantage plans may include coverage for shower chairs. Since coverage does vary, it’s advisable to confirm with Medicare or your plan provider beforehand.
Remember, the goal is to maintain your independence and safety while bathing. A shower chair could be a worthwhile investment in ensuring you can carry out your daily activities with comfort and confidence.
If you’re finding that moving around the bathroom or getting in and out of the tub is becoming challenging, installing grab bars can provide the extra support you need. Grab bars are sturdy metal bars attached to the wall of your bathroom or shower that you can hold onto for support when standing, sitting, or moving.
Grab bars come in different shapes and sizes. They can be horizontal, vertical, or angled, depending on what best suits your needs. Horizontal bars can assist you when you’re rising from a seated position, while vertical bars are often beneficial for steadying yourself as you move around. Angled bars can offer a combination of these benefits.
When choosing and installing grab bars, it’s essential to think about where they will be most useful to you. Common places include next to the toilet and in the shower or bathtub. You might need to reach out to a professional installer to ensure they’re securely attached to the wall, as a poorly installed grab bar may lead to falls or injuries.
Keep in mind that while grab bars can significantly increase safety in your bathroom, Medicare typically doesn’t cover their cost. They’re considered “home modifications,” not durable medical equipment, and therefore aren’t included in your Medicare benefits.
However, the cost of purchasing and installing grab bars can often be relatively low, and the benefit of added safety and independence in your bathroom can be well worth the investment.
When getting to the bathroom becomes a challenge for you due to mobility issues or other health conditions, a commode chair might be an excellent solution. Commode chairs, also known as bedside commodes, are portable toilets that can be used in any part of your home, ensuring you have safe and convenient access when you need it.
Commode chairs typically have a sturdy metal or plastic frame, a seat with an opening, and a container underneath to collect waste. Many also come with armrests and back support for added comfort and stability when you’re sitting down or standing up.
One of the benefits of a commode chair is its versatility. Some models can be used as raised toilet seats or shower chairs, making them a multipurpose tool for maintaining your independence and safety at home.
When you’re choosing a commode chair, there are a few factors you’ll need to consider. These include the chair’s weight capacity, height adjustability, the ease of cleaning, and how comfortable the seat is. Some chairs also come with wheels, offering additional flexibility in moving the chair where it’s needed.
Medicare Part B provides coverage for commode chairs as durable medical equipment (DME) when prescribed by your doctor for in-home use, specifically if you are confined to your bedroom. Once you’ve met the Part B deductible, you’ll be responsible for paying 20% of the Medicare-Approved Amount.
If stepping over the side of a traditional tub or balancing on a slippery surface is causing you concern, a walk-in tub could be a good solution for you. Walk-in tubs are designed to offer a safer and more comfortable bathing experience, especially if you have mobility issues.
These tubs come with a watertight door that allows you to walk directly into the tub, rather than having to step over a high edge. Once you’re inside, you can sit on a built-in seat while the tub fills with water. There are also grab bars inside to assist with moving and balancing. When you’re finished bathing, you simply drain the water before opening the door to exit the tub.
Walk-in tubs can often be customized with therapeutic features like whirlpool jets, heated backrests, or fast-fill and fast-drain capabilities. These features can make your bathing experience even more relaxing and enjoyable.
However, it’s important to be aware that the installation of a walk-in tub is considered a home modification and isn’t covered by Medicare. Additionally, walk-in tubs can be a significant investment, as costs include not only the tub itself but also installation by a professional.
If stepping into a tub or shower is becoming a challenge for you, a transfer bench could be the answer. Transfer benches are designed to help individuals who have mobility issues get into and out of the shower more safely and comfortably.
A typical transfer bench extends over the side of your tub, with two legs resting on the bathroom floor and two inside the tub. You can sit on the bench outside of the tub, then safely slide over into the tub while remaining seated. This eliminates the need for you to step over the tub wall, reducing the risk of slips and falls.
Transfer benches come in different designs to meet your specific needs. Some have padded seats for extra comfort, others have cut-out sections to assist with personal cleaning. You might prefer a bench with a backrest for additional support, or one with suction cups on the legs for extra stability.
When selecting a transfer bench, consider the weight capacity, adjustability, and the size to make sure it fits your tub. Also, the bench should be easy to clean and have a non-slip surface for safety.
Unfortunately, Medicare won’t cover a transfer bench or any bathroom safety device that is used for comfort. While transfer benches can significantly increase safety and accessibility in your bathroom, they’re typically seen as “convenience items” rather than necessary medical equipment.
Do Medigap Plans Cover Bathroom Equipment?
Medigap, also known as Medicare Supplement Insurance, is designed to cover costs that Original Medicare (Part A and Part B) does not cover fully, such as copayments, coinsurance, and deductibles. Medigap policies are sold by private insurance companies and can help fill in some “gaps” in Original Medicare coverage.
Medigap policies typically do not extend to the coverage of home safety equipment or modifications, such as bathroom safety equipment. This means things like grab bars, shower chairs, raised toilet seats, or transfer benches generally are not covered by Medigap plans.
Medigap plans primarily focus on covering out-of-pocket costs related to services approved by Medicare. If Medicare doesn’t cover a service or item, then the Medigap policy typically won’t cover it either.
Do Medicare Advantage Plans Cover Bathroom Equipment?
Medicare Advantage Plans, also known as Medicare Part C, are offered by private companies that contract with Medicare to provide all your Part A (Hospital Insurance) and Part B (Medical Insurance) benefits. Most Medicare Advantage Plans also offer prescription drug coverage.
Medicare Advantage Plans can offer benefits not covered by Original Medicare, which can include wellness programs, vision, dental, and hearing care. The specifics of what each Medicare Advantage Plan covers can vary widely between insurance providers and individual plans.
Regarding bathroom equipment or modifications, while Original Medicare typically does not cover these, some Medicare Advantage Plans may provide expanded benefits that could include certain home modifications or safety equipment if they are deemed medically necessary. It’s important to remember that this is highly dependent on the specific plan and its terms.
Therefore, if you have a Medicare Advantage Plan and are considering bathroom safety equipment, the best course of action is to contact your plan provider directly to verify what is and isn’t covered under your specific plan. Always confirm coverage details before making any healthcare decisions or purchases.
The need for bathroom modifications is a crucial aspect of home safety for seniors and those with certain medical conditions. It’s clear that Medicare doesn’t cover the majority of bathroom safety equipment, with the exception being commode chairs. Understanding the nuances of your specific Medicare plan, whether it’s Original Medicare, Medigap or a Medicare Advantage Plan, is key to maximizing your benefits and ensuring a safer, more accessible bathroom environment.
Still have questions? We’re here for you. Give us a call at 866-MEDIGAP (866-633-4427). Senior Healthcare Solutions is dedicated to helping you navigate the complexities of Medicare, making it simple and straightforward for you. Our team of licensed Medicare agents is available to provide you with personalized guidance and assist you in finding the most suitable plan for your unique healthcare needs. We look forward to speaking with you soon!