Which Home Upgrades and Improvements Are Covered By Medicare?
Aging is a double-edged sword. It opens up new adventures and freedoms as you step into retirement and have time to do things you didn’t before, such as spending time with grandchildren, traveling, volunteering, and learning new crafts or trades.
Unfortunately, aging can also bring about a decline in health that can damper the plans you’ve been anticipating. When this happens, it can become difficult or even impossible to do what you’ve always done. Tasks you performed without even thinking, such as getting into and out of a bathtub, walking upstairs, standing on the step-stool to reach things, or just hearing the doorbell or telephone ring become difficult.
Modifying your home to help you accomplish everyday tasks that have become hard to handle might seem like an easy fix – and it can be if the improvements are financially obtainable. If the modifications you need are covered by Medicare, you’d be out 20% of the covered cost plus your deductible (if you don't have a Medicare Supplement).
If the improvements aren’t covered, it could cost you hundreds, or even thousands, of dollars.
Does Medicare Cover Home Upgrades and Improvements?
The answer to this question is probably not.
While Medicare doesn’t cover many home improvements that will undoubtedly make your life easier, Medicare Part B does cover some items that can help you deal with difficulties as you age.
Any medically necessary durable medical equipment (DME) that’s prescribed by your doctor for use in your home is covered.
Medically Necessary Durable Medical Equipment (DME)
According to Medicare.gov, some DME covered by Medicare Part B are:
- Blood sugar monitors and test strips
- Commode chairs
- Continuous passive motion devices
- CPAP devices
- Hospital beds
- Infusion pumps and devices
- Lancets and lancet devices
- Nebulizers and nebulizer medications
- Oxygen equipment and accessories
- Patient lifts
- Pressure-reducing beds, mattresses, and mattress overlays
- Suction pumps
- Traction equipment
- Wheelchairs and scooters
If your doctors and DME suppliers are enrolled in Medicare, you’ll pay 20% of the Medicare-approved amount, and the Part B deductible applies. Medicare covers the cost for different kinds of DME in different ways. Depending on the type of equipment and qualifying diagnosis you:
- May need to rent the equipment
- May need to buy the equipment
- You may be able to choose whether you want to rent or buy the equipment
Home Improvements for Seniors
While many DME are important and may be necessary, there are also some home improvements that are important and may be necessary as well. For example, a doctor probably isn’t going to prescribe a walk-in tub, but it’s important to have a safe place to bathe yourself, and if all you have is a bathtub/shower that you have to crawl in and out of, you’re risking a fall every time you use it.
Medicare or Medicare Part B doesn’t typically cover this type of home improvement unless it’s prescribed by your physician. Adding modifications to your home to help with everyday tasks can cause a financial strain because they’re unexpected out of pocket expenses.
Here are some common home modifications and the average cost:
- Walk-in tubs: $2,000-$5,000 plus the cost of installation
- Stairlifts: $2,000-$5,000 plus the cost of installation
- Handrails for tubs, commodes, hallways, etc.: $65-$500 plus the cost of installation
- Lower cabinets and/or shelves: start around $300 and can reach into the thousands depending on what needs to be done
- Transfer benches: basic benches start around $65 and can cost as much as $3500 depending on many factors such as where it will be used, whether it is manual or electric, etc.
- Lever-type handles on sinks, tubs, and doors: start around $25 and can cost as much as several hundred dollars depending on what and how many you need
If, by chance, one of these or any other home modification is prescribed by your physician and deemed medically necessary, the modification would probably be covered by Medicare Part B.
It’s important to realize that if your doctor prescribes a stairlift because he feels it’s medically necessary for you, the cost of the stairlift will be covered, but the cost of the installation wouldn’t be covered. You could still have an unexpected out of pocket expense to consider.
[Related Reading: Will Medicare Pay for a Lift Chair?]
Where Can You Get Help With Home Modifications Not Covered by Medicare?
There are organizations that offer grants, loans or financial help for home improvements for seniors. The following are a few places you can look to for help:
- Administration for Community Living: believes that older adults should be able to live where they choose and be productive citizens within their community. Through networks of community-based organizations, and with investments in research, education, and innovation, they help make this principle possible for millions of seniors.
- Paying for Senior Care: discusses
several home modifications seniors may need such as:
- Climate controls
- Easy use fixtures
- Grab bars and rails
- Push button door openers
- Stair lifts
- Transfer benches
- Wheelchair and ramps
- Financial loans, grants, labor loans, and equipment loans may also be needed for home modifications
- Daily Caring
- Area Agency on Aging: home modifications and repairs may be available through the Older Americans Act
- Home energy update assistance providers: low-income households might be eligible for help with paying for energy related costs and repairs
- Rebuilding Together: a national nonprofit organization that helps with repairs and home modifications to promote health, safety, and independence
- Department of Agriculture: grants are provided to very-low-income and low-income elderly through the Section 504 Home Repair program for health and safety home repairs
- Sliding scale and reduced fee contractor services: some contractors will make home modifications for seniors for a reduced fee or on a sliding scale based on their income
- Insurance: some long-term insurance policies cover some home modifications
Home Improvements – Necessary but Costly
As aging brings about a decline in physical strength and stability, making changes to your home in order to live comfortably and independently as long as possible seems like a simple and sensible thing to do.
These improvements can be very expensive and may not be covered by Medicare. Talking with your doctor about the improvements you need to stay in your home and be productive is a great first step to securing your independence.
If the modifications you need aren’t deemed medically necessary by your physician, there is still hope. Check out the websites suggested above, you might be able to find the financial help needed to make changes that’ll keep you living comfortably in your own home.
You can always contact us here at Medicare Allies and we’ll help you in any way we can.
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