A raised toilet seat can be a great piece of bathroom equipment that improves elderly safety and quality of life.
But, raised toilet seats can be an unexpected cost. Does Medicare cover raised toilet seats?
Considering how much Medicare covers, it makes sense that what this program covers or doesn’t cover has a huge effect on what can be purchased.
Unfortunately, many seniors won’t like the answer to this question, so let’s dive into whether or not Medicare covers raised toilet seats.
Does Medicare Cover Raised Toilet Seats?
Medicare currently does not cover the expense of buying raised toilet seats, even if they are recommended by your approved health physicians. Fortunately, they aren’t very expensive to purchase on your own (see the best raised toilet seats here)
This is because, in general, Medicare considers toilet safety equipment which includes (but is not limited to) safety frames, risers, and, yes, even elevated toilet seats, to be classified as items of personal convenience versus medical necessity.
Because of this, Medicare does not cover them.
At least base Medicare does not, though it’s worth checking up on your individual plan seeing as how in some cases, there might be supplemental OTC benefits under Medicare Advantage that would potentially cover some or all of the cost.
Understanding Medicare Part B
Medicare Part B is the part of Medicare that is there to cover deemed medically necessary equipment that is allocated as Durable Medical Equipment (DME).
In some cases, this could include raised toilet seats, but only if your approved doctor or healthcare professional prescribed it specifically for in-home use. Even then, it’s probably only covered if you have special supplemental insurance coverage.
That means the seat must be:
- FDA approved
- Used for a medical purpose
- Ordered by your doctor or other healthcare providers
Even then, the full amount is probably not going to be covered, but this might allow partial coverage in some situations when that additional OTC coverage kicks in.
If you have Medicare Part B, you usually pay 20% of the Medicare-approved amount for the seat, and the Part B deductible applies.
However, some states may have programs that help people with limited incomes and resources pay for some or all of their Medicare out-of-pocket costs.
The best option many at-home care elders will have for getting at least some of raised toilet seats covered is through this route.
Medical Charities And Support
There are many charities or outside organizations that work to bring additional support and plug the gaps where Medicare or conventional programs fall short in coverage.
These organizations will know what all the available options are to help get matched up with funds, equipment, or programs that are most likely to be able to help.
Other Bathroom Upgrades
This doesn’t mean that a medically helpful bathroom improvement will always be vetoed by Medicare. There are multiple improvements that are going to be partially or wholly covered depending on the specific situation and how it is viewed medically.
Depending on your individual situation and coverage, Medicare may cover certain types of bathroom upgrades.
Medicare Part B covers medically necessary durable medical equipment (DME) like:
- Grab bars
- Shower chairs
Always look at your specific plan as coverage can vary greatly, especially if you have additional supplemental coverage.
Raised Toilet Seats Are Often Worth The Expense
Not just for the extra pressure off of the knees and back, but the overall comfort and ease is a quality of life improvement that goes hand in hand with better medical support. Plus, raised toilet seats are a safe way to improve bathroom safety.
Even on a limited budget, it’s still worth looking at what these can offer in terms of upgrading the bathroom.
Most elders on Medicare are not going to be able to get their raised toilet seats covered under Medicare, even if it is with a doctor’s recommendations. This is because of that problematic listing as an item of convenience.
However, for many individuals finding themselves struggling a bit more going in and out of the bathroom, this is an expense that is well worth it.