January 3, 2025

Are Shower Seats Covered by Medicare?

Generally, Original Medicare (Parts A and B) does NOT cover shower seats because they are typically considered “convenience items” rather than medically necessary equipment for diagnosing or treating a medical condition, also known as “durable medical equipment” (DME.)

What classifies as “durable medical equipment” (DME)?

Durable Medical Equipment (DME) refers to medical equipment used for long-term use in the home. To be classified as DME, an item must generally meet the following criteria:   

• Durable: It must be able to withstand repeated use, meaning it’s not a disposable item.
• Medically Necessary: The equipment must be primarily used to serve a medical purpose related to a diagnosed health condition
• Not Useful Without Illness: The equipment is typically not useful to someone in the absence of illness or injury.
• Used in the Home: The equipment is intended for use in the patient’s home, not in a hospital or other healthcare facility.

A few examples of durable medical equipment include wheelchairs, hospital beds, oxygen equipment, walkers, crutches, etc. However; it’s important to note that this is a general definition, and specific coverage criteria for DME may vary depending on the insurance provider (like Medicare) and the specific item.

Are there any exceptions to Medicare coverage for shower seats?

Yes, while Original Medicare typically doesn’t cover shower chairs, there are some exceptions. Medicare Advantage plans, offered by private insurance companies, may have broader coverage that includes shower seats. Depending on your state, Medicaid might also cover them if they are deemed medically necessary by a doctor. Additionally, veterans may be eligible for coverage through the VA if the shower seat is considered medically necessary for their condition.

It’s important to remember that even with these exceptions, a doctor’s prescription is usually required to demonstrate the medical necessity of the shower chair. To determine your specific coverage, it’s crucial to contact your Medicare plan, Medicaid provider, or other relevant insurance companies directly. They can provide the most accurate and up-to-date information regarding coverage for shower chairs in your particular situation.

What are the requirements for Medicare coverage of a shower seat?

For Medicare to cover a shower seat, it must be deemed medically necessary by a doctor. This means your doctor needs to:

1. Prescribe the shower seat: They must write a prescription specifically stating that the shower seat is essential for your medical care and safety.
2. Document the medical necessity: The doctor needs to clearly document in your medical records why the shower seat is necessary for your health condition.

You should always consult with your doctor and your specific Medicare plan for the most accurate and up-to-date information on coverage for shower seats.

How can I find out if my Medicare plan covers shower chairs?

To determine if your Medicare plan covers shower seats, it’s essential to contact your specific plan directly. Medicare Part B, which covers durable medical equipment, generally does not include shower seats as they are typically considered “convenience items.” However, Medicare Advantage plans (Part C) offered by private insurance companies may have broader coverage that includes shower seats.

You can usually find your plan’s customer service number on your insurance card or member ID card. Calling them is the most direct way to get specific information about your coverage. You can also review your plan’s Evidence of Coverage (EOC) document, which outlines your plan’s benefits and limitations.

Remember, even if your plan covers shower seats, you will likely need a doctor’s prescription stating that the chair is medically necessary for your health condition.

If you are in need of shower seats, take a look at our wide variety of options here: Shower Seats