Whether or not Medicaid covers shower chairs is a major question for anyone who could benefit from easier showers. This issue is complicated and not as straightforward as it might seem.
Medicaid covers shower chairs, but only under a limited set of circumstances. The basic idea is that Medicaid covers shower chairs when they are physically and medically necessary, but not if they are just for making showers easier. You should know the finer details of how Medicaid approaches these types of assistance devices.
Here’s the full details of whether Medicaid covers shower chairs.
Does Medicaid Cover Shower Chairs?
What’s the full scoop behind Medicaid covering shower chairs?
Medicaid considered shower chairs to be durable medical equipment, but they aren't always covered by Medicaid. Shower chairs can be covered by Medicaid when your physician deems them medically necessary, but they are not covered without a prescription.
You also might need a shower chair on a temporary basis. Individuals who are recovering in a treatment center or hospital can make use of a shower chair during the recovery. Medicaid can cover the cost of a shower chair used while you are in a long-term treatment program.
Medicaid is serviced both by state and federal agencies. This means the specifics of your Medicaid coverage are going to change from state-to-state. For example, the state of Illinois covers long-term and hospital care in addition to other types of medical treatment with Medicaid.
In short, Medicaid does not often cover shower chairs when you are buying them, but they might cover the cost of using them when at a hospital or other treatment program.
What is Durable Medical Equipment
Medicaid has a specific policy when it comes to covering the cost of medical devices. These devices are known as Durable Medical Equipment. DME are often covered, but it all depends on the specific of these devices.
Durable Medical Equipment needs to meet some specific requirements. These devices need to be used in your home, used for a specific medical condition, can be used repeatedly, and expected to last at least three years.
Shower chairs meet these criteria. However, Medicaid does not consider shower chairs to be necessarily used for specific medical conditions. This means they are not essentially covered by Medicaid and only can only be covered under certain circumstances.
Medicaid regularly publishes updates to their Durable Medical Equipment policies that you can follow on the Medicaid DME webpage.
What Types of Shower Chairs are Covered by Medicaid?
There are four basic categories of shower chair that are covered by Medicaid. Your shower chair will need to meet one of these basic categories in order for Medicaid to cover the cost of this device.
There are many types of shower chairs within these categories. Shower chairs can have wheels, be able to recline, or be as basic as a stool to offer stability while showering.
How to Buy a Shower Chair With Medicaid?
Here’s the easiest way to buy a shower chair with Medicaid. You don’t need to do any guesswork or worry about whether your store accepts Medicaid.
Your first step is going to be finding a doctor that accepts Medicaid. You can use the Health and Human Services website to search through a database of doctors who take Medicaid. You can also call around to local physicians and see whose offices and which hospital are currently accepting Medicaid.
Your doctor can then prescribe you a medically necessary shower chair, transfer bench, or a different type of bath aide. The next step will be to get that prescription filled at a pharmacy that accepts Medicaid. Most major pharmacies, like Walgreens, accept Medicaid when paying for a shower chair.
If you're not certain whether your pharmacy accepts Medicaid, make sure to call them in advance before the prescription order is placed.
What if Medicaid Doesn’t Cover My Shower Chair?
If Medicaid doesn’t cover your shower chair, you do have a few options for finding an affordable shower chair.
Your first step should be to check your local Medical Supply Bank. These are usually non-profit groups that provide their communities with free medical devices. Their stock is based on the donations they get, so you might have to call around to find one that works for you.
You can also check your local resale shops. Places like Goodwill often carry shower chairs. They are commonly donated items.
The last place that you can check for a shower chair is online stores. Amazon, Walmart, and eBay all have shower chairs that you can purchase for a reasonable cost. eBay even has discounted or used shower chairs that can save you plenty of cash.
Am I Eligible for Medicaid?
It can be difficult to determine if you're eligible for Medicaid. You should check the Medicaid Eligibility website for full information, but we're going to go over a basic guide to help you get started.
The Affordable Care Act expanded Medicaid coverage in the United States. Individuals at or below 133% of the federal poverty line are now eligible for Medicaid.
Individuals over the age of 65, people who are deemed “medically needy”, people with an existing and severe illness, and other individuals can often qualify for Medicaid even if they don't meet the financial requirements.
Wrapping Medicaid and Shower Chairs
Here’s a quick recap of everything we have covered about buying shower chairs with Medicaid.
The first thing you need to know is that Medicaid does not often cover the cost of a shower chair. Medicaid views these devices as not always medically necessary which means they do not cover them.
However, Medicaid can cover shower chairs in rare circumstances. These include individuals who have severe mobility issues and other conditions that make them medically necessary. Your doctor can help you determine if you can get a medically prescribed shower chair.
If Medicaid doesn't cover your shower chair, you should consider shopping around resale shops like Goodwill or local online markets like Craigslist. You can also pick up a free shower chair from your local Medical Equipment Bank if they happen to have any in stock.