It can be frustrating and confusing trying to figure out how to get help paying for equipment that can make showering easier and safer - even if you’re looking on behalf of a loved one.
With insurance, Medicare, Medicaid, and potentially other intercessors to go through to get funding or reimbursement, it can seem like there’s a lot of red tape.
Still, we are here to help. We rounded up some of the most common questions, along with some potential answers here.
(Note: the answers to some of these questions may not apply to you or your loved one based on your living conditions, insurance coverage, the state in which you reside, and other factors. This is only intended to serve as a guideline and not as legal counsel.)
How Do I Get Funding for a Shower Chair or Sliding Shower Bench?
As opposed to paying for an elder shower chair or sliding shower bench out of pocket, there are other avenues that might be able to provide you (or a loved one) with funding for such equipment.
Depending on your unique circumstances, insurance, Medicaid (and state subsidiaries), and even Medicare may be able to provide funding or reimbursement for bathroom equipment that are used for medical purposes. SSDI, or Social Security Disability Insurance benefits may also apply towards funds or reimbursements for such equipment.
Does Insurance Cover Bathroom Equipment?
Whether or not your private health insurance coverage will cover bathroom equipment depends on the terms and conditions of the policy. It certainly might, but the level of coverage or reimbursement will also depend on factors such as copay and deductibles.
To get a full answer, you will need to contact your insurance provider. You might also need to get your doctor to order them for use in your home for medical purposes.
Does Medicare Cover Bathroom Equipment?
Generally, Medicare does not cover bathroom equipment because they are categorized as convenience items rather than as medical devices.
However, Medicare Part B does provide coverage for items that are considered DMEs, or “durable medical equipment” provided they meet certain criteria. To qualify as DME, sliding shower benches, shower chairs and other similar equipment must:
- Be durable (must be able to withstand repeated uses)
- Have an expected lifetime of at least three years
- Be used only for a medical reason
- Be used in your home
- Not be useful to someone who is not sick or injured
Your doctor may prescribe DME, which you will then need to get from a supplier that accepts such orders. The amount of coverage provided will depend on your Medicare plan as well as any supplemental insurance you have, along with other factors.
(Note: Coverage may vary, but in general, the small shower benches in our Refine line do not qualify for coverage.)
Is a Shower Chair a Medical Device?
A shower chair may be considered a medical device (by Medicare, at least) if it meets the criteria outlined in the previous section. However, as a general rule, Medicare Part B defines shower chairs as convenience items that are not usually covered.
Can a Doctor Write a “Prescription” for a Shower Chair?
Doctors can write prescriptions for shower chairs or other similar items if they consider them medically necessary for your health or safety. Consult your primary care provider for more specific information.
What Is the Grant for Disabled People in the U.S.?
There’s more than one grant that issues funds to individuals in the United States living with disabilities. Some of them are:
- Medicare
- Medicaid (working in conjunction with the states)
- Supplemental Security Income (SSI)
- Social Security Disability Insurance (SSDI), which is intended to assist people that are living with an emotional, mental, or physical disability that lasts 12 months or longer or results in loss of life.
There are also several private grants that you might be interested in looking into:
- Elderly or Disabled Living Grant, which provides assistance to people over the age of 55 who meet certain criteria.
- Joseph Groh Foundation Grant, which provides assistance for individuals who have sustained life-altering injuries while working in construction.
Why Would Someone Need a Sliding Shower Bench or a Shower Chair?
There are many reasons why someone might need a sliding shower bench, shower chair, or some other assistive device. One might be the natural loss of mobility and coordination as a result of aging. Life-altering injuries that result in paralysis or loss of mobility may be another cause, as may be congenital disabilities.
In any case, our shower benches and other assistive devices span a broad range. In our catalog there are options suitable for those that only need help getting into the shower, such as sliding transfer benches, as well as roll-in shower chairs for those that need a caregiver to assist them more completely.
A Note on Regulations/Coverage by State
Because the regulations regarding state participation in and provision of Medicaid coverage vary, it is important to note that what is covered in one state may not be covered in another. Contact your provider for more information.
Special Information Concerning California Residents
Medi-Cal, which is California’s Medicaid program, may offer coverage for assistive medical bathroom devices to those living with disabilities. Our official dealers have very high success rates getting approval for coverage from Medi-Cal, Medicaid, and private insurance providers. Our dealers will even come to your home and make sure one of our transfer devices works in your home before submitting a request for approval.
For parents with disabled children: If your child receives services from the CCS (California Childrens’ Services program) or an MTU (Medical Therapy Unit), he or she may be eligible for approved transfer devices and receive compensation for it through Medi-Cal.
We interviewed one of our dealers in California recently about this process. Check out the video on our official YouTube channel for more information.
Questions About Our Sliding Shower Benches? Contact Us!
Still have questions about our sliding shower benches, chairs and other transfer devices? We are here to help. Get in touch with us and let us know how we can help today.
