February 6, 2024

Are Shower Seats Covered by Insurance?

Unfortunately, shower seats are not typically covered by most insurance plans, including Original Medicare (Part A and Part B). This is because they are generally classified as “convenience items” rather than “durable medical equipment” (DME).

What is Durable Medical Equipment (DME)?

• Equipment that is medically necessary: It must be used to treat a specific medical condition and improve your ability to perform daily activities.
• Equipment that is durable: It is expected to last for at least three years with normal use.
• Equipment that is not primarily used in the absence of illness or injury: This means it wouldn’t be useful to someone who is healthy.

While a shower seat can provide safety and comfort, it doesn’t necessarily meet all these criteria; however, there may be a few exceptions.

Are there any situations where I might be able to get some coverage for a shower seat?

Yes!

1. Medicare Advantage Plans: These plans are offered by private companies and must cover at least the same benefits as Original Medicare. However, many Medicare Advantage plans offer additional benefits, including over-the-counter allowances that can be used to purchase items like shower seats. Check with your specific plan to see if this is an option.
2. Medicaid: This program provides health insurance for low-income individuals and families. Depending on your specific situation and state Medicaid program, you might be able to get coverage for a shower seat if it is deemed medically necessary.
3. Private Insurance: Some private insurance plans may offer coverage for shower seats, but this is not common. Check with your individual plan to see if coverage is available.
4. Other Resources: There are also some organizations that offer financial assistance for shower seats, such as the Veterans Administration or disability assistance programs.

How can I find out if my insurance covers shower seats?

• Call your insurance company and ask about their specific coverage for shower seats.
• Check your plan’s website or member handbook.
• Talk to your doctor about whether a shower seat is medically necessary for you.

It’s important to check the details of your insurance policy or contact your insurance provider directly to understand whether shower seats are covered and under what conditions. If you believe that a shower seat is necessary for your safety or the safety of a family member, it’s advisable to consult with a healthcare professional who can assess your needs and provide documentation that may support a claim for coverage.