Does Medicare Cover Home Safety Devices?
October 19, 2023
One-Third Of Seniors Over The Age of 65 Experience Falls Each Year
Bathroom safety is a paramount concern for seniors, as a simple slip and fall can have life-altering consequences. According to the National Institute On Aging, one-third of seniors over the age of 65 experience falls each year, with the bathroom being a common site for these accidents.
Recent studies have shown that for people aged 65 and older, falls account for approximately 60 percent of all injury-related Emergency Department Visits and over 50 percent of injury-related deaths annually. And up to 80 percent of falls in the home occur in the bathroom. These fall-related injuries can range from minor scrapes and bruises to broken bones, head injury and spinal cord injury.
The good news is that there are various safety devices available to reduce the risk of such incidents, but the question remains: Does Medicare cover bathroom safety devices?
The Bathroom: A Risky Territory For Seniors
For many seniors, the bathroom is a daily obstacle course where potential hazards lurk around every corner. Reduced vision, muscle weakness, and balance issues can make navigating this small space a treacherous endeavor. A simple stumble can result in severe injuries, potentially compromising an individual's ability to live independently.
The bathroom presents several challenges for seniors, including slippery surfaces, awkwardly positioned fixtures, and the need to reach for items. To mitigate these risks, there are practical steps seniors can take to enhance their bathroom safety:
Install Grab Bars:
Installing sturdy grab bars near the toilet, shower, and bathtub can provide essential support for seniors when moving around the bathroom.
Adding non-slip mats or coatings to the bathtub and shower floor can significantly reduce the risk of slipping.
Ensure that everyday essentials are within easy reach, eliminating the need for seniors to overextend themselves.
Remove any obstacles or clutter from the bathroom that may obstruct movement or pose tripping hazards.
Installing a night light in the bathroom can help seniors navigate the space safely, especially during nighttime visits. Additionally, clear labeling of hot and cold water faucets is essential to prevent accidental burns.
Consider Walk-In Showers:
Replacing traditional bathtubs with walk-in showers can make entry and exit much easier and safer for seniors.
Consult Your Doctor:
Discuss your concerns about bathroom safety with your healthcare provider. They can offer personalized advice and recommendations based on your specific needs and mobility limitations.
While these measures can significantly enhance bathroom safety, some seniors may require additional assistance in the form of medical equipment.
Can Medicare Help With Bathroom Safety Devices?
Medicare, the federal health insurance program primarily designed for seniors aged 65 and older, can provide coverage for specific medical equipment when prescribed by a doctor. This coverage falls under Medicare Part B (Medical Insurance) and encompasses what is known as Durable Medical Equipment (DME). To be eligible for coverage, DME must meet certain criteria:
• It must be durable and capable of withstanding repeated use.
• It should be intended for a medical purpose.
• It must be necessary due to a medical condition or injury.
• It is designed for use in the home.
• It should have an expected lifetime of at least three years.
While Medicare covers essential mobility aids such as canes and walkers, it's important to note that most bathroom safety devices, like grab bars and raised toilet seats, are typically considered "convenience items" rather than medically necessary equipment. Therefore, they fall outside the scope of Medicare coverage, and individuals will need to pay for them out-of-pocket.
However, there is a caveat to this. Commodes, which can aid individuals confined to a room without bathroom facilities, may be covered under Part B's Durable Medical Equipment benefits if prescribed by a doctor.
Medicare Advantage plans may cover bathroom grab bars, and it's possible that Medicaid or VA benefits may help pay for a shower chair.
A Medicare Supplement plan, sometimes also called Medigap – can help pay for your out-of-pocket Medicare costs. Medicare Supplement Plans are accepted by any provider who accepts Medicare, including Durable Medical Equipment Providers.
If your doctor prescribes Durable Medical Equipment that is covered by Medicare, you'll need to obtain it from a supplier that accepts assignments. This ensures that you pay the standard Medicare-approved amount for the equipment. However, if your doctor or the supplier does not participate in Medicare, you may be responsible for the full cost of the equipment.
For those with Original Medicare (Part A and Part B), there is typically a 20% coinsurance requirement for Medicare-Approved DME. This means you'll be responsible for paying 20% of the cost. However, if you're enrolled in a Medicare Advantage (MA) Plan, your coverage may differ.
While Medicare plays a crucial role in assisting seniors with various healthcare needs, bathroom safety devices often fall outside the realm of covered equipment. Seniors must remain proactive in taking steps to enhance bathroom safety and consider budgeting for these essential devices to ensure a safer, more independent, and accident-FREE living environment.
Consultation with your healthcare provider and a thorough understanding of your Medicare coverage with a Medicare professional can help you make informed decisions about your bathroom safety. By doing so, you can enjoy greater peace of mind and maintain your independence in the comfort of your own home.