Does Medicare cover Bath Safety Items?
There is a large variety of Bath Safety equipment avaialbe to make toileting, showering and bathing easier and safer. Many falls happen in the bathroom because moist air make surfaces slippery, and especially dangerous with a smooth tile floor. Some bath safety and personal care products are covered by Medicare and Supplemental Insurance. A Commode Chair is partially covered by Medicare, if the user has:
- Illness has left the body unstable and weak, making trips to the bathroom difficult and dangerous due do falls.
- Surgery has temporarily left a person too weak to walk the distance to the bathroom.
- Joint problems and aging have weakened the legs, making it difficult for an individual to get on and off the toilet.
- Balance problems that make it difficult for an individual to safely travel to and get on/off the toilet.
How Do I Qualify for a Commode Chair?
In order to qualify, the doctor must write a prescription and document your need in your medical records. Medicare requirements are different for each type of commode chair. For example, Medicare will cover a bedside commode under the following situations:
- Illness keeps you confined to one room
- Disability makes it difficult to use the toilet
- Beneficiaries confined to a home level with no bathroom
- Beneficiaries living in a home with no bathroom
If you receive your Medicare benefit through a Medicare Advantage or MediGap/Medicare Supplemental plan, call and ask how to qualify for a commode chair. Regardless of your coverage, a supplier may be able to answer questions about qualifying for the equipment.
How Much Does it Cost?
You may rent or purchase commode chairs. Your cost will depend on which type of Medicare coverage you receive. For example:
- Medicare covers 80% of their approved amount; you are responsible for the remaining amount.
- If you have a MediGap/Medicare Supplemental Plan, call and ask what is covered by the plan.
- If you have a Medicare Advantage Plan, call your plan and ask what is covered and what your share of cost is.
Where Do I Purchase Commode Chairs?
You will save money if you order your items from a Medicare-approved provider that accepts the assignment. You may also buy commode chairs from any store that sells them. However, if the supplier from which you order your bed is not enrolled in Medicare, Medicare will not pay for the equipment.
Things to review before you choose a supplier:
- There are two types of Medicare suppliers: participating suppliers, and those who are enrolled but have chosen not to participate.
- Participating suppliers will not charge more than the Medicare allowed amount.
- A Medicare approved provider who does not want to participate can charge more than the Medicare-approved amount. However, they cannot charge more than 15% above the Medicare-approved amount. They may also ask you to pay the entire bill when you pick up the bed. In this situation, Medicare will send the reimbursement directly to you. However, be prepared to wait; it may take a couple of months to receive payment.
- If you receive your Medicare coverage through a Medicare Advantage Plan (like an HMO or PPO), it is likely that the plan will have its own steps for the purchase. In addition, the plan may have restrictions on which suppliers you can use.
Other Bath Safety Products
Some bath safety productrs are considered personal convenience items and are not covered by Medicare. These items include:
- Some Commode Chairs
- Raised Toilet Seats
- Shower Chairs
- Commode Wheelchairs
- Grab Bars