Paying for Walk-in Tubs: Medicare's Benefits and Other Financial Help

Medicare’s Policy on Walk In Bathtubs

Unfortunately for most seniors, walk in bathtubs are not considered to be durable medical equipment by original Medicare. Thus, original Medicare will not pay for the cost of a walk-in tub nor will they contribute to the cost of installation.

Having said that, there may be rare situations in which original Medicare does provide financial assistance. When this occurs, the support comes as reimbursement, rather than in advance of the purchase. The tub would have to be considered an absolute medical necessity. The beneficiary would need a medical diagnosis that proves his/her need. In addition, a written prescription that outlines the reasons for which a walk in tub is necessary, as well as any features specific to a brand is required. Even with all this support, there is no guarantee of original Medicare’s assistance. When it comes to original Medicare, it is best to think of the tub as an out-of-pocket purchase, submit one’s claim, and hope for the best. However, one should be financially prepared to pay the full cost, including installation. Or look for other sources of assistance.

While getting original Medicare to cover the cost of walk in tubs is very difficult, Medicare Advantage (regulated by Medicare, but run by private insurance companies) may be a different story. In April of 2018, the Centers for Medicare and Medicaid Services (CMS) announced the expansion of health related supplemental benefits through Medicare Advantage (MA) plans. That said, the term “health related supplemental benefits” is not exactly defined by CMS and is left open to interpretation. However, the service (or, in this case, item) should be utilized to:

• Prevent, diagnose, or treat a disease or injury
• Make up for physical injuries/weaknesses
• Better the functional and/or psychological effect of physical/heath issues
• Assist in reducing the need for emergency care.

In April of 2019, CMS announced that future Medicare Advantage plans will be able to offer additional supplemental benefits. These do not have to be health related and are intended for persons with chronic illnesses. In addition, these supplemental benefits can be customized to specifically meet the needs of the person who is chronically ill, given they provide “a reasonable expectation of improving or maintaining the health or overall function” of that individual.

Based on this loosely provided guidance, it is our understanding that some MA plans will pay for the cost of walk in tubs. Please note: Supplemental health (and non-health) benefits will vary based on the state in which one resides, as well as one’s specific Medicare Advantage plan.

Medicaid’s Policy on Walk In Tubs

Even with Medicare Advantage plans offering supplemental healthcare and new supplemental non-healthcare benefits, Medicaid is more likely to provide financial assistance for the purchase and installation of a walk in tub. Medicaid is not a single federal program. Instead, each state has several different Medicaid programs. Therefore, there are possibly 100s of different sets of rules governing Medicaid’s policy on the purchase of a walk in tub or “low threshold shower.” For example, Medicaid in California (Medi-Cal) has programs for pregnant women, infants, nursing home care, and assisted living. None of these Medi-Cal programs will pay for a walk in tub. However, the state had a Medicaid program called Community Transitions that helped nursing home residents move back to private homes. This program, which ended in January 2019 due to lack of funding, very likely would have covered the cost of a walk in tub. That said, the program may resume in the future if funds become available.

There are also Medicaid programs for Home and Community Based Services (HCBS). For example, Colorado has an Elderly, Blind and Disabled Persons Waiver. This will pay for “specialized medical equipment” and “environmental accessibility modifications.” Under these guidelines, when medically necessary to help an individual remain living in their home, Medicaid will pay the purchase price and installation costs for a walk in tub.

Each state has different Medicaid HCBS waivers. To determine if your state will pay for a walk in tub, you should examine the benefits of your state’s Medicaid waivers to see if they will pay for durable medical equipment, assistive technology, home modifications or environmental accessibility adaptations. A complete list of Medicaid waivers relevant to the elderly can be found here.

Veterans Benefits and Walk In Tubs

It is difficult to make a blanket statement about the Department of Veterans’ Affairs policy of paying for a walk in tub, as well as the home modification costs to install the tub. It is perhaps more beneficial to consider individual programs offered by the VA.

TRICARE and CHAMPVA – with these insurance programs, it would be difficult to receive assistance for a walk in tub, as they do not consider them to be durable medical equipment. TRICARE for Life and CHAMPVA for Life function much like Medicare Supplemental Insurance programs. If TRICARE and CHAMPVA will not pay, then it is unlikely TRICARE for Life and CHAMPVA for Life will pay either.

Home Modification Grants – On a more positive note, there are several VA programs that provide assistance that can be used for the purchase and installation of a walk in tub or roll in shower. The VA offers 3 different grants for disabled veterans:

• Specially Adapted Housing (SAH) Grant
• Special Home Adaptation (SHA) Grant
• Home Improvements and Structural Alterations (HISA) Grant

Of these, the HISA Grant is the most applicable to aging veterans as their disability need not be connected to their military service. In other words, veterans who require a roll in shower simply because of aging challenges may qualify under the HISA Grant. Please note that a roll in shower is different from a walk in tub and HISA Grants do not cover walk-in tubs.

Veteran-Directed Care Program (VDC) – This is a program modeled after Medicaid’s Consumer Directed HCBS. With VDC, participants are provided with a set budget for their care requirements and given a certain amount of flexibility to spend that budget on the services and supplies they determine as necessary. Under this program, a veteran may choose to allocate a portion of the allowance toward the purchase and installation of a walk in bathtub or shower. Learn more about VD-HCBS.

VA Aid and Attendance, Housebound and other Pensions – These pensions have no specific limitations as long as they are used for the care of the beneficiary. Therefore, these benefits can be used for walk in tub purchases and installations. Moreover, persons receiving these pensions can receive assistance above and beyond their current benefit specifically to pay for the cost of a walk-in tub or roll-in shower. A walk-in tub can be considered an unreimbursed medical expense for VA income calculating purposes. This means the cost of the walk-in tub is deducted from one’s income. And the veteran will receive an increased pension benefit in the amount of the deduction, which will cover the cost of the tub. Learn more about how the VA calculates income here.

Other Financial Assistance for Walk In Tubs

There are several other options which can help pay for a walk in tub, though it should be noted that these are not necessarily available to everyone.

Somewhat surprisingly, there is a grant available from the U.S. Department of Agriculture that helps elderly, low income residents of rural areas make home modifications to enable aging in place. These grants can be used for home and safety improvements including the addition of a walk in tub to one’s bathroom. Learn more here.

Some states have non-Medicaid financial assistance programs for the elderly that can be used for home modifications such as walk in tubs. Unfortunately, only a handful of states have these programs at present. A list is available here.

On occasion, non-profit organizations have community initiatives that can offset the installation costs of a walk-in tub. It should be noted that these organizations typically do not pay for the cost of materials (i.e. the cost of the walk in tub). One such program with a national footprint is called Rebuilding Together.

Finally, some manufacturers of walk in tubs offer financing that can convert a large upfront payment into a monthly bill. Monthly payments of between $80 and $150 can be expected.

Tax Deductibility of Walk In Tubs

If a walk in tub is purchased for medical safety reasons, it can be considered a medical expense. Therefore, the materials and the installation costs are tax deductible as a Medical and Dental Expense. If one is caring for an elderly parent in their home and they make a home modification that includes the addition of a walk in tub, the homeowner can claim the expense under the Dependent Care Tax Credit. Some states have their own version of this credit; click here to learn more.

Purchase and Installation Costs of Walk In Tubs

Walk in tubs, the most basic versions, can be purchased for between $2,000 – $5,000. However, the most basic versions often are not designed to accommodate individuals who predominantly use wheelchairs and those who have difficulty transferring themselves. Wheelchair accessible walk in tubs are typically twice as expensive as the basic version; one should expect to pay between $5,000 – $10,000. There is a great deal of variance in the installation costs of walk in tubs, largely depending on one’s existing bathroom design and if other changes are needed to accommodate for wheelchair access. The most basic installation can take only 4-8 hours of work, but rarely are the installations so cut and dry. There are tilework, plumbing, hot water heater, and old tub removal considerations. As well as the cost of labor in one’s local area (a plumber in New York may charge twice as much as one in West Virginia). One should expect to pay between $700 – $5,000 to have a tub installed.

The easiest way to determine your costs is to get a free, non-binding installation quote. You can obtain multiple quotes from several local home modification professionals at no obligation by completing this short form.

There are other costs associated with the installation of a walk-in tub. The table below shows cost ranges for common related bathroom safety products.

To see our in-depth coverage on walk-in tubs, see our review here.

Purchasing Used Walk In Tubs

It is possible to purchase a walk in tub in used condition. However, in reality, this rarely happens due to the removal and shipping challenges. Both of which can easily damage a tub. Most individuals decide the cost savings of purchasing used does not warrant the risk of a damaged or leaky tub as well as the hassles associated with transporting the tub to a new location. Furthermore, many families have hygiene concerns when it comes to purchasing used bathing equipment.

Alternatives to Walk-in Tubs

Walk-In Tubs vs. Roll-In Showers
The most common alternative to a walk in tub is a roll in shower, also called a low threshold shower. Most showers have a 3-6 inch step at the base designed to contain the water as it drains. These ridges can be higher if the shower doubles as a normal tub. These thresholds prevent wheelchair bound persons from entering the shower. A roll in shower has no threshold so a wheelchair can roll directly into the showering space or to a transfer bench. An extra benefit is the bather does not have to wait for the water to fill and drain during usage.

Funding options and financial assistance for roll in showers are the same as for walk in tubs. Original Medicare only pays in very rare occasions. But currently some, and potentially more Medicare Advantage plans in the future, may fund roll in showers. That said, Medicaid and VA benefits are more likely to help with the costs. Roll in showers can be less expensive than walk in tubs. However, the total cost depends more on the bathroom design and installation and less so on equipment costs. Most trained contractors are proficient in either tub or shower installations. Quotes for roll in showers are also available free of charge and without obligation. Finally, there are portable roll in showers as well. These are meant as temporary solutions and require considerable effort to set up and take down. Surely more effort than could be put forth by the individual desiring to use such a product. A friend or family member would be needed to set up and take down the shower. As they require considerable room space as well, they are unlikely to be left standing between uses.

Tub Manufacturers

A list of walk in tub manufacturers available in the U.S. is included below to help families in their research.

• American Standard
• Best Bath
• Bliss
• Boca Walk-In Tubs
• Dignity
• Kohler
• Meditub
• Premier Care
• Rane
• Safe Step Tub
• Thera Tub