Does Insurance Cover Walk-In Tubs?

Insurance coverage for walk-in tubs

Insurance plans rarely cover the cost of walk-in tubs because they are typically classified as permanent home modifications rather than durable medical equipment (DME). Medicare defines DME as long-lasting medical devices designed for home use, such as canes, walkers and hospital beds. By contrast, home modifications involve permanent structural changes to accommodate a disability.

While rare exceptions exist through certain private health or long-term care policies, coverage depends heavily on the policy's fine print and usually requires a doctor's prescription or a letter of medical necessity.

Because exceptions do exist, a denied claim may be worth a closer look. Blaine Rogers, managing partner at Davis Levin Livingston, advised policyholders to review denials carefully.

Rogers explained that an insurer may be acting in bad faith if it unreasonably refuses to review a claim, especially when it “fails to follow its own claims procedures or ignores evidence demonstrating medical necessity.” If your doctor prescribes a walk-in tub and your policy may provide coverage, it could be worth challenging a denial with supporting documentation.

Medicare coverage for walk-in tubs

Original Medicare (Parts A and B) generally doesn’t cover walk-in tubs because it classifies them as structural home modifications rather than DME. While Part A covers hospital stays and Part B covers outpatient care and DME, neither part pays for home renovations. According to Peter Abilla, a licensed Medicare agent at Resting Sycamore Advisors, getting coverage through original Medicare is essentially unheard of. He said none of his clients have ever received approval, even when backed by a doctor's prescription.

However, beneficiaries do have an alternative in Medicare Advantage (Part C), which provides Medicare-approved coverage through private insurers. Since guidelines expanded in 2019, some Medicare Advantage plans offer supplemental home safety benefits. Abilla pointed out that these plans “sometimes carry a home safety benefit — grab bars, a shower seat or occasionally a small annual allowance.”

Medical necessity and reimbursement steps

While an annual allowance can help offset installation costs, full coverage for a walk-in tub remains rare even under Part C. Abilla advised reviewing your Evidence of Coverage document or contacting your plan provider directly to confirm your specific benefits.

If your plan does offer an allowance toward a tub, you’ll typically need a doctor's letter of medical necessity. You may also have to buy from a Medicare-enrolled supplier, pay upfront and then submit receipts for reimbursement.

Medicaid coverage for walk-in tubs

Medicaid tends to be a more viable option for walk-in tub coverage compared to Medicare, although guidelines depend heavily on the state. The majority of financial support comes through state Home and Community-Based Services (HCBS) waivers designed to support aging in place.

Abilla explained that “the whole point of those programs is keeping people out of facilities.” However, caps, eligibility and waitlists vary by state. Individuals who are dual-eligible for both Medicare and Medicaid should start by researching these state waivers.

State Medicaid rules and eligibility

Because HCBS waivers go by different names depending on where you live, your first step should be looking up your state’s specific program. For instance, North Carolina operates the Community Alternatives Program for Disabled Adults (CAP/DA), which requires applicants to be 65 or older or have a disability, face a risk of nursing home placement and meet strict financial limits.

To apply, contact your local Medicaid office or area agency on aging to start the process. You’ll typically work with a case manager who assesses your functional needs and gathers the required documentation, which almost always includes a doctor's prescription or letter of medical necessity stating that a walk-in tub is essential for your safety.

Keep in mind that states like California, Colorado and New York generally offer more favorable coverage for home modifications. Even in these states, approval can take months. You may also have to pay upfront and request reimbursement or choose from a limited list of approved Medicaid contractors.

» LEARN: How much do walk-in tubs cost?

Other ways to pay for walk-in tubs

Even if you aren't eligible for Medicare or Medicaid, several alternative funding options can help cover the cost of a walk-in tub:

• Veterans benefits: Eligible veterans can apply for U.S. Department of Veterans Affairs (VA) housing grants, such as the Home Improvements and Structural Alterations (HISA) grant, the Special Home Adaptation (SHA) grant or the Specially Adapted Housing (SAH) grant. Depending on service-connected disability status, these can cover a significant portion — or even the full cost — of a walk-in tub installation.
• USDA Section 504 Home Repair Grants: Very-low-income seniors (aged 62 and older) living in eligible rural areas can apply for a USDA Section 504 grant, which offers up to $10,000 to eliminate health and safety hazards or improve home accessibility.
• Long-term care insurance: Some long-term care policies include a home modification benefit that covers equipment like a walk-in tub if it allows you to age in place safely. Be sure to check your specific policy details and required prerequisites with your provider.
• HSA or FSA funds: You may be able to use Health Savings Account (HSA) or Flexible Spending Account (FSA) funds to pay for a walk-in tub, provided you obtain a letter of medical necessity from your physician first.
• Tax deductions: If you itemize your taxes, the cost of installing a walk-in tub for medical reasons may qualify as a deductible medical expense under IRS guidelines. However, you should always consult a tax professional before purchasing to confirm what qualifies.

Walk-in tub funding options compared

The following table compares eligibility requirements and potential assistance for each funding source:

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