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Is a Shower Chair Covered by Medicare or Other Insurance?

Is a Shower Chair Covered by Medicare or Other Insurance?

Medicare does pay for shower chairs as a covered medical expense. However, some Medicare Advantage plans and other insurers will pay for them. Learn why below.
Scott Grant, CSA®, SHSS®
By:
Scott Grant, CSA®, SHSS®
Scott Grant, CSA®, SHSS®

Scott Grant, CSA®, SHSS®

With over 20 years of experience and certifications as a Certified Senior Advisor (CSA)® and Senior Home Safety Specialist (SHSS)®, Scott Grant provides reliable recommendations to help seniors maintain independence through informed product and service choices for safe, comfortable living.

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Shower Chair Covered By Medicare
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For the elderly, mobility and safety while engaging in daily activities can often be a challenge. Simple activities like showering can be full of risks.

An elderly person is often not strong enough to stand in the shower because of balance issues, weakness in the legs, and other physical limitations. A solution to this may be as simple as getting a shower chair.

So, do your research looking for the best shower chairs for the elderly .

Then, the next question is, is a shower chair covered by Medicare or other insurance?

Unfortunately, Medicare by itself generally does not, but Medicare in conjunction with additional insurance may provide some benefits that are worth exploring.

What Does Medicare Say About Shower Chairs?

To understand why Medicare does not cover shower chairs, you must understand what Medicare says about Durable Medical Equipment (DME). Medicare defines DME as equipment that fulfills the following criteria:

  • It has to be used at home
  • It has to be reusable
  • It has to last a minimum of three years
  • It has to be used for a defined medical purpose

You can say that the shower chair passes the first three tests, but it fails the fourth. It is not something that fulfills a specific medical necessity – according to Medicare, at least.

Also, a DME must have a prescription from a physician who accepts Medicare. The doctor works with an equipment supplier approved by Medicare and agrees to accept Medicare for the DME.

A shower chair and many other bathroom conveniences like safety rails do not fall into this category.

shower chair covered by Medicare other options
Contact your Medicare Advantage plan representative to know if your plan covers shower chairs.

Are There Other Options That Might Cover A Shower Chair?

Medicare Advantage plans may have additional benefits, including the coverage of shower chairs. However, these plans charge a monthly premium, and you might have to pay a deductible for the extra coverage.

A third-party insurer provides advantage plans and often has additional coverage for over-the-counter items that are not included in Medicare. 

There are many types of different Medicare Advantage plans. Call your plan representative and request a written explanation of your benefits to determine whether your plan covers shower chairs.

Medicaid Coverage

If you also have Medicaid, there is a possibility that it might cover specific equipment used in the bathroom that Medicare does not cover. It depends on the Medicaid program in your state.

If the chair is strictly used in the shower, it probably will not be covered by Medicaid. However, it may be eligible if the chair has advanced features that you can use to support toileting needs.

To get a clear answer about what Medicaid says about shower chairs, you need to contact the Medicaid office in your state.

Non-Insurance Options

Shower chairs come in different designs with different features. You may be able to find a shower chair that has the features you need in a price range that you can afford.

The cost can vary widely. You can shop at large retailers like Amazon or Walmart to check their options and prices if you have to pay out-of-pocket.

shower chair covered by Medicare non-insurance options
A friend or a relative can help you build your shower chair.

Another option is to see if you have a friend or family member handy with building things and can make you a shower chair. The chair does not need to have a complicated design.

It just has to be sturdy and waterproof. The bottom of the legs of a shower chair should have material that is non-slip to prevent the chair from sliding around in the shower. And of course, the chair needs to support your weight.

Summarizing The Possibilities

A shower chair is necessary for safety reasons when a senior has balance or mobility problems.

Although Medicare does not usually cover it, Medicare Advantage plans or Medicaid may provide additional coverage for things that Medicare generally does not cover.

To get the most out of your medical benefits, check with the plan’s benefits provider or your state’s Medicaid office.

A shower chair is an excellent addition to the bathroom to improve safety in the shower. If you do not have insurance covering a shower chair, many affordable shower chairs are available to fit your needs.

Check the big-box stores and take advantage of sales. So, it is worth the time to explore the best options to acquire one.

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Scott Grant, CSA®, SHSS®

Scott Grant, CSA®, SHSS®

With over 20 years of experience and certifications as a Certified Senior Advisor (CSA)® and Senior Home Safety Specialist (SHSS)®, Scott Grant provides reliable recommendations to help seniors maintain independence through informed product and service choices for safe, comfortable living.

Learn More Email

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