Does Medicare and Medicaid pay for handicap bathroom remodeling?

August 25, 2016

accessible tub from a bathroom modification

Bath Doctor is a certified contractor for Medicare and Medicaid and is approved to handle your Medicare and Medicaid claims for bathroom and kitchen modifications as prescribed by your doctor. While Medicare and Medicaid are different, there are many home modifications that can be completed that may be covered by them. The working parts of Medicare parts B and C cover different equipment so depending on which plan you belong to there may be some limitations.

What is covered by which plan?

Medicare Part B covers a wide variety of what’s called “durable medical equipment” for use in a patient’s home. Some equipment must be rented, some purchased, and sometimes the patient has a choice. Equipment must be medically necessary and prescribed by a doctor. Covered equipment can include special commodes, showers, bathtub devices and safety bars. Medicare Part B pays 80 percent of the Medicare-approved amount for the rental or purchase of covered equipment.

If you have the part C Medicare Advantage plan, then your plan must cover everything that’s included in original Medicare Part B coverage, including durable medical equipment, it can sometimes cover more, with lower co-payments for medical equipment.

Not always, but in general, if you’re enrolled in your state’s Medicaid program, it will cover the same types of durable medical equipment covered by Medicare Part B. If you have Medicaid but not Medicare, you’ll be charged a small co-payment for use of the equipment. If you have both Medicaid and Medicare, Medicaid will pay all of the 20 percent that Medicare doesn’t pay, except for a small co-payment.

What kind of modifications can I have done?

There are many home modifications, especially in the bathroom that can make it more efficient for those with medical and mobility issues. Not all are covered by insurance but some of the major common modifications include:

  • special commodes
  • lower toilets and dispensers
  • Low barrier showers
  • Barrier Free showers
  • Walk in Tubs
  • handicap accessible vanities
  • Wheel chair access wall mounted sinks
  • bidet
  • grab bars
  • shower seats, curbless showers
  • adjustable shower heads

Will you handle the insurance for me?

We understand how difficult it can be to understand and manage any insurance, but especially Medicare and Medicaid. That is why we work hard with the insurance companies so that you don’t have to. We will also be up front about what your costs are and what is covered, that way you are comfortable with the project and aware of your expenses. If you have needs that are not covered by insurance or want upgrades that are higher end than your insurance will cover, we are happy to accommodate special requests and have access to many quality specialized products to modify and upgrade your bathroom for comfort and mobility. Contact us today and we’ll help you understand your options with insurance coverage.

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