Medicare Coverage for Home Modifications
One of the major questions we get asked in the field of home modifications and aging in place accessibility is “What does Medicare cover?”.
That is a very valid question; but unfortunately answering it is not so simple.
We hope to simplify and clarify some of the basics when it comes to Medicare and home modifications.
We will keep it quite simple over here to stick to the basic standards. There are exceptions and special circumstances where someone can get more to be covered but each case will be so individual that we cannot possibly go through all situations over here.
Therefore, we decided to provide you with the general “rules” as well as some leads to further resources where you can hopefully find out what you can get covered for your unique case.
What does Medicare Cover?
According to Medicare Interactive (a provider education center for Medicare rules, regulations and standards):
“Medicare never covers home modifications, such as ramps or widened doors for improving wheelchair access. Though your doctor may suggest that home modifications may help due to your medical condition, Medicare does not include coverage for them under its durable medical equipment (DME) benefit. Medicare also does not cover assistive devices, such as large-button telephones or flashing doorbell signals.”
In other words, Medicare will generally not cover structural changes or modifications to make the home more accessible. What they do cover though, are some very specific and basic pieces of equipment which they term “Durable Medical Equipment.”
Durable Medical Equipment
The exact definition of Durable Medical Equipment is:
“Medicare Part B covers durable medical equipment (DME), which is equipment that serves a medical purpose, is able to withstand repeated use, and is appropriate for use in the home.”
Some examples include:
- Blood sugar monitors
- Blood sugar test strips
- Canes
- Commode chairs
- Continuous passive motion devices
- Continuous Positive Airway Pressure (CPAP) devices
- Crutches
- Hospital beds
- Infusion pumps & supplies
- Lancet devices & lancets
- Nebulizers & nebulizer medications
- Oxygen equipment & accessories
- Patient lifts
- Pressure-reducing beds, mattresses, and mattress overlays
- Suction pumps
- Traction equipment
- Walkers
- Wheelchairs & scooters
To search if a different item or service that you have in mind is covered, use the search feature on the Medicare Website as linked over here.
Conclusion
Those are the basics when it comes to Medicare coverage. Unfortunately, many services and pieces of adaptive equipment which would increase safety and independence in the home are not Medicare’s priority.
But, if you read through many of our posts where we go through different rooms in the home with tips and solutions for increasing accessibility, you can find the best and cheapest options to purchase on your own. And the best part about it is that we did the research for you! Following are just a few of the links to our posts with different practical, useful and positively reviewed devices which can make all the difference to the safety and independence in your home.
That’s that for Medicare Coverage for Home Modifications.
We hope this was helpful!
As always, contact us with any comments/questions.
To safe and happy homes,
Golda
Golda, a licensed Occupational Therapist and Certified Aging in Place Specialist (CAPS professional) was inspired to specialize in an area which she felt would increase her clients’ quality of life beyond typical therapy treatment sessions. Golda embraces the idea of increasing clients’ abilities to reside in their homes barrier-free as providing a level of quality of life which cannot be matched. Follow along with Golda on her journey of creating a comprehensive resource center for home accessibility modifications here at adapttostay.com.