Does Medicare Cover Shower Chairs?
Original Medicare (Medicare Part A and Part B) generally does not cover shower chairs, but some Medicare Advantage plans might. Medicare Part B covers outpatient care, preventive services, and certain medical equipment that does not include shower chairs. It typically only provides coverage for durable medical equipment (DME) items if they meet the following criteria:
- Intended to be used in your home
- Prescribed by a doctor
- Used for a specific medical necessity
- Able to be used repeatedly
- Expected to last for at least three years
While having a chair in the shower can decrease your chances of injuries while showering, Medicare Part B does not deem them medically necessary. Some Medicare Advantage plans, however, offer over-the-counter allowances that cover certain items, such as a shower seat.
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The Benefits of Shower Chairs: A Helping Hand
Shower chairs are a type of bathroom aid that allows you to stay seated in the shower and lower your risk of falling and injuring yourself. Anyone can benefit from a chair in the shower, though older adults and people with mobility issues may need them most. Some of the most common types of shower seats include:
- Shower chairs with backrests
- Shower chairs with arm support
- Shower chairs with wheels
- Transfer benches
- Foldable shower chairs
- Shower stools
- Aluminum bath chairs
While a shower seat can provide a helping hand to those who need it, getting it covered by Medicare can be challenging.
Limitations on How Original Medicare Covers Shower Chairs
Though Original Medicare covers most of your medical expenses after you turn 65, you may still find gaps in its coverage for items such as shower chairs. Medicare Part B typically limits coverage for shower seats since they’re considered convenience items rather than medical necessities. Medicare Part A, which helps pay for inpatient stays at a hospital or skilled nursing facility (SNF), may cover the use of a shower chair while you’re admitted to a facility — but that coverage ends when you check out.
While Part B generally does not cover shower chairs, an exception may possibly be made if you have medical issues and your doctor orders a chair for use in your home. If this is the case, Medicare will typically cover 80% of the approved amount for durable medical equipment. The remaining 20% may be your responsibility, unless you have additional coverage through a supplemental insurance plan. The most likely scenario, however, is that you will have to pay fully out of pocket for a shower seat.
How Does Medicare Advantage Cover Shower Chairs?
Medicare Advantage plans are sold by private health insurance companies and are required to provide at least the same coverage as Original Medicare. Some of these plans come with additional benefits, such as an over-the-counter (OTC) allowance. This allowance, which typically ranges from $100 to $500, is distributed quarterly and could be used to purchase items such as vitamins, supplements, shower seats, grab bars, and other qualifying items.
If you have one of those plans, you can use the OTC allowance to cover shower chairs. Contact your plan provider to learn more about accessing the allowance.
How Much Do Shower Chairs Cost?
Most shower seats are relatively affordable. For example, options at Target start as low as $29.99. But if you want a more deluxe and high-quality seat, you can expect to pay up to $300. Depending on the amount of your Medicare Advantage over-the-counter allowance, you may be able to cover your entire purchase.
What Durable Medical Equipment Does Original Medicare Cover?
Shower chairs are not considered durable medical equipment (DME), which is why they’re generally not covered by Original Medicare. Medicare Part B coverage defines DME as medical equipment that helps you complete your daily activities. It must be durable, serve a medical purpose, be appropriate for use in the home, be prescribed by your doctor, and have a lifespan of at least three years.
Here’s a list of DME that is generally covered by Original Medicare:
- Wheelchairs and Scooters
- Walkers
- Hospital Beds
- Oxygen Equipment
- CPAP Devices
- Nebulizers
- Feeding Tubes
- Blood Glucose Monitors
If you’re unsure whether something is considered DME and covered by Medicare, contact your Medicare representative for clarification.
How to Find Coverage for Shower Chairs
If you need assistance in the bathroom but do not have a Medicare Advantage plan, consider covering the cost of a shower seat through the following avenues:
- Private Insurance: If you have private health insurance, check with your insurance agent to see what coverage options you may have for shower chairs.
- Out-of-Pocket Payment: If you do not wish to invest in private health insurance, consider saving up to purchase a chair out of pocket. Paying a one-time cost may make more financial sense than monthly health insurance premiums.
- Non-Profit Organizations: Charities or non-profit organizations such as MedShare and the American Medical Resource Foundation may assist those who need mobility aids such as shower seats.
Putting it Together
Slips and falls in the shower can lead to serious medical emergencies such as broken bones, traumatic head injuries, and even brain damage in some cases. Consider purchasing a shower seat to decrease your chances of suffering from such injuries in the shower. And if you need help covering the cost, Medicare Advantage and private health insurance plans might offer assistance.