While Original Medicare Doesn’t Pay For Bathroom Remodeling, Some Medicare Advantage Plans Do
- Some Medicare Advantage (Medicare Part C) plans cover bathroom remodeling to install grab bars, walk-in tubs, widened doorways and more. Original Medicare (Parts A and B) doesn’t currently pay for bathroom remodeling, though it can cover other home health aids.
Some Medicare Advantage (Medicare Part C) plans cover bathroom remodeling and other home modifications to help older adults age in place. Original Medicare – Part A and Part B) – which is provided by the federal government, doesn’t cover bathroom remodeling, but it does pay for some other home health care services and assistive technology.
Aging in place involves growing older in your own home as opposed to being in a retirement home or assisted living facility. To live comfortably and safely at home, it can help to make some modifications to your home to make it easier for to navigate.
One of the rooms most commonly modified is the bathroom, as this can be one of the most dangerous rooms in the home. In this guide, we outline how and when Medicare may cover bathroom remodeling and other home modifications.
Does Original Medicare Pay for Bathroom Equipment?
While Original Medicare doesn’t currently cover bathroom remodeling, Medicare Part B can help cover some services and items of durable medical equipment (DME) to be used in the home:
- Medicare Part B will pay for an occupational therapist to evaluate a home and determine what kind of modifications are medically required for aging in place.
- Part B will pay for a commode chair if you cannot safely use a regular toilet and a commode chair is ordered by your doctor. If the DME supplier of your bathroom chair accepts Medicare assignment, you will typically pay only 20% of the Medicare-approved amount for the cost of your commode chair, after you meet your annual Part B deductible.
- Part B may also cover assistive technology devices that are part of your home modifications, as long that they are required for medical reasons and prescribed by a doctor.
Some Medicare Advantage Plans Pay for Walk-In Tubs and More
Medicare Advantage plans, or Medicare Part C, are sold by private insurance companies. By law, these plans must provide all of the same minimum coverage as Medicare Part A and Part B, which means all Medicare Advantage plans will provide the same coverage discussed above.
Once that minimum requirement is met, Part C plans may then offer some additional benefits of their own. Most Medicare Advantage plans offer prescription drug coverage, and many plans also offer dental, vision and hearing benefits that Original Medicare doesn’t cover.
More and more Medicare Advantage plans now may cover bathroom remodeling and home renovations.
Some of the bathroom and home remodeling benefits that some Medicare Advantage plans may pay for can include:
- Walk-in tubs or showers
- Bathroom grab bars
- Traction strips for stairs or tubs
- Wheelchair ramps
- Stair lifts
- Raised toilet seats
- Widened doorways and halls
Many Medicare Advantage plans are encouraging aging in place by expanding coverage for home-related services and items. Some increasingly popular Medicare Advantage plans benefits may include things like home meal deliveries, non-emergency medical transportation, adult day care, medical alert systems and more.
In addition, some Medicare Advantage plans may cover non-skilled care, or “custodial” care in the home. Custodial care can include assistance with bathing and toileting provided by a caregiver. These services are not covered by Original Medicare if it’s the only care that is needed.
How Much Does Bathroom Remodeling Cost With Medicare?
Any home modifications or durable medical equipment covered by Medicare Part B will be subject to the annual Part B deductible (which is $203 for the year in 2021) followed by a 20% coinsurance payment for any remaining balance.
If you have a Medicare Advantage plan, your bathroom remodeling costs will depend on the terms of your respective plan. You can reach out to your plan carrier for specific cost and coverage information.