A Medicare denial for a bathtub seat or raised toilet seat doesn't decide whether Medicaid will pay, because Medicaid equipment coverage isn't limited to the items Medicare covers. So does Medicaid cover shower chairs, bath seats and tub lifts? Your parent's state decides, using its own definition of medical equipment and its own medical-necessity rules. What federal rules guarantee is a fair process: a state can't rule equipment out entirely, it has to consider a request for an item that isn't on its list, and it has to tell you about the right to a fair hearing if it says no.

In This Guide

Why Medicare Said No to the Bath Seat

A Medicare denial for a bath seat rests on how Medicare classifies the item. The Centers for Medicare & Medicaid Services (CMS) keeps a reference list of durable medical equipment (DME) in its National Coverage Determinations Manual, and that list goes item by item.

CMS's list treats the bathroom items families ask about most like this.

Item Medicare's answer Stated reason or condition
Bathtub seat Denied A comfort or convenience item and hygienic equipment, not primarily medical in nature
Bathtub lift Denied A convenience item, not primarily medical in nature
Raised toilet seat Denied A convenience item and hygienic equipment, not primarily medical in nature
Toilet seat Denied Not medical equipment
Commode Covered with a condition The patient is confined to bed or room, which can also be met when the patient's condition confines them to a floor of the home with no bathroom on it
Patient lift Covered with a condition Medicare contractor medical staff determine that periodic movement is necessary to improve the patient's condition or slow its decline

CMS's Medicare DME list gives no condition under which Medicare covers bathtub seats, bathtub lifts, raised toilet seats or toilet seats. So a doctor's letter or a second request to Medicare isn't likely to change the answer for those four items. Commodes and patient lifts are different, because Medicare covers them when the condition in the table is met. When Medicare covers equipment like this, the person generally pays 20% of the Medicare-approved amount after the Part B deductible, which is $283 in 2026.,

Behind all of this sits Medicare's own definition. Medicare.gov defines DME as equipment that is durable, used for a medical reason, typically only useful to someone who is sick or injured, used in the home, and expected to last at least 3 years. That five-part test is Medicare's. Medicaid uses a different one.

Does Medicaid Cover Shower Chairs? A Separate Question From Medicare

Medicaid home health care is a state-plan benefit, which means it's part of every state's regular Medicaid program rather than an optional Home and Community-Based Services (HCBS) 1915(c) waiver. Under the federal home health regulation, 42 CFR 440.70, medical supplies, equipment and appliances are required items that every state must cover within the home health rules, outside any HCBS waiver.

Two parts of that regulation matter most for a family holding a Medicare denial. First, state Medicaid coverage of equipment and appliances is not restricted to the items Medicare covers as DME. Second, a state can keep a list of preapproved equipment for administrative ease, but states are prohibited from having absolute exclusions of coverage on medical equipment, supplies or appliances.

That second rule comes with a process. The state must have a way to request items that aren't on its list, it must judge those requests by reasonable and specific criteria, and when it denies a request it must tell the person about the right to a fair hearing. When CMS added these provisions in a 2016 final rule, it said a Medicaid beneficiary must be given the chance to show that the item is medically necessary and fits within the state's overall definition of covered medical equipment.

What Counts as Medical Equipment for Medicaid

The federal definition is short. Under 42 CFR 440.70(b)(3), equipment and appliances are items that are primarily and customarily used to serve a medical purpose, generally aren't useful to someone without a disability, illness or injury, can withstand repeated use, and can be reusable or removable.

States fill in the rest. In its 2016 final rule, CMS said states keep the flexibility to adopt a reasonable definition of medical supplies, equipment and appliances consistent with the federal framework, and may set medical-necessity and utilization-control standards. That's why the honest answer to "does Medicaid cover bath seats" is that your parent's state decides. Medicare's list calls these items comfort, convenience or hygienic equipment, and a state may or may not see a particular request the same way once it has your parent's medical reasons in front of it.

One line is firm. CMS said in the same rule that the costs of structural home modifications aren't covered under the Medicaid home health benefit, because they fall outside the definition of medical equipment and would instead be costs of shelter. A removable seat or a raised toilet seat is a request for equipment. Rebuilding the bathroom, such as converting a tub into a walk-in shower, is a different kind of request, and our guide on how to pay for home modifications covers the waivers and other programs that may help with that.

How to Ask Medicaid for a Shower Chair or Bath Seat

The request runs through your parent's own Medicaid program, so the details (forms, suppliers, who to call) vary by state. The federal steps underneath are the same everywhere.

  1. Get a practitioner's order. Medicaid equipment must be ordered by a physician or other licensed practitioner acting within the scope of practice that state law allows, as part of a written plan of care, and your parent's need for it must be reviewed every year.
  2. Ask whether a face-to-face visit is required. For medical equipment, Medicaid's face-to-face rule applies only to the extent Medicare would require a face-to-face encounter for the same item as durable medical equipment. Where it does apply, the visit has to relate to the main reason your parent needs the equipment and take place no more than 6 months before the equipment starts. Ask the ordering doctor's office or your parent's plan whether the rule applies to the item you're requesting.
  3. Find out who decides. If your parent gets Medicaid through a managed care plan, the plan decides, and federal rules require it to give written notice of any denial. If not, ask the state Medicaid agency how equipment requests work in your parent's state.
  4. Ask whether the item is on the state's list. If it isn't, ask the supplier, the plan or the agency for the state's process for requesting items not on its list. Every state must have one.
  5. Explain the medical reason in writing. The request should show why your parent needs the item for a medical purpose: a fall in the tub, a hip that won't bend far enough for a standard toilet, a therapist's note on transfers. Keep copies of the order, any Medicare denial and everything you send.

If Medicaid Says No: Appeals and Fair Hearings

A denial is the start of the appeal process, not the end of the request. Federal Medicaid law gives a fair hearing before the state agency to anyone whose claim for covered benefits or services is denied, and the regulation lists a prior authorization decision among the decisions a person can challenge.

How you get to that hearing depends on how your parent gets Medicaid.

If your parent is in a Medicaid managed care plan

The first stop is the plan's own appeal. Your parent has 60 calendar days from the date on the plan's denial notice to ask the plan for an appeal, and the request can be made orally or in writing. Under federal rules, the state's deadline for the plan to decide a standard appeal can't be longer than 30 calendar days from when the plan receives it, and an expedited appeal can't take longer than 72 hours.

If the plan upholds the denial, the state must give your parent at least 90 and no more than 120 calendar days from the plan's decision notice to request a state fair hearing, and each state picks its own number within that range. If the plan misses its notice or timing requirements, your parent is treated as having finished the plan's appeal and can go straight to a state fair hearing.

Use the denial notice itself. A plan's notice must explain the reasons, and your parent has the right to free copies of the documents behind the decision, including the medical-necessity criteria the plan used. Ask for those criteria. They tell you exactly what the doctor's letter needs to address.

Some people with both Medicare and Medicaid are in an integrated plan that follows a different set of appeal rules, so check the deadline printed on your parent's notice rather than assuming the 60 days.

If your parent has regular (fee-for-service) Medicaid

The request for a fair hearing goes to the state. In fee-for-service Medicaid, federal rules give a reasonable time to request a state fair hearing, no longer than 90 days from the date the notice of action is mailed. The 90 days is a ceiling, and a state can set a shorter window, so the deadline that counts is the one on your parent's notice.

Who can help at the hearing

Your parent doesn't have to go alone. Federal rules require the state to tell applicants and beneficiaries in writing that they may represent themselves or use legal counsel, a relative, a friend or another spokesperson. An adult child who has been managing the request is often the right person, and our guide to Medicaid appeals and fair hearings walks through what happens at the hearing itself.

Other Places to Ask

If Medicaid still says no, or your parent doesn't have Medicaid, two other routes are worth a call.

If your parent has a Medicare Advantage plan, it may offer bathroom safety devices as a supplemental benefit, and that benefit can include installation and an in-home bathroom safety inspection by a qualified health professional. No plan has to offer it, and whether a plan covers bathroom safety devices, which items and at what cost depends on that plan, so ask the plan in writing.

Every state also has an assistive technology program funded through the Administration for Community Living (ACL). Under the federal Assistive Technology Act, these programs can run short-term device loans, reuse programs that pass along equipment someone no longer needs, and alternative financing such as low-interest loans, though each state may run as few as two of its four activities. The federal grant can't pay directly for a device for one person, so ask your parent's state assistive technology program whether it can lend, reuse or help finance the item.

Frequently Asked Questions

Does my parent need to be on a Medicaid waiver to ask for a bath seat?

No. CMS said in its 2016 final rule that states may not restrict equipment that meets the home health coverage criteria to people who qualify for a section 1915(c) or 1915(i) program. A waiver comes in when the need is a change to the home itself rather than a piece of equipment: home modifications generally aren't a Medicaid state-plan service and reach families through a waiver instead, and only if the state's own waiver covers them.

Does my parent have to be homebound to get Medicaid equipment?

No. Under 42 CFR 440.70, Medicaid home health services can't be limited to people who are homebound, and they can be received in any setting where normal life activities take place, other than settings such as a hospital or nursing facility.

Can a nurse practitioner do the face-to-face visit for equipment?

Often, yes. When a face-to-face encounter is required for medical equipment, supplies or appliances, it can be done by a licensed practitioner acting within the scope of practice state law allows, and nurse practitioners and physician assistants can also do it as state law allows.

Will Medicare or Medicaid pay for grab bars?

Original Medicare won't. CMS's Medicare DME list denies grab bars as a self-help device that isn't primarily medical in nature, with no stated condition under which Medicare covers them. A Medicare Advantage plan may offer bathroom safety devices as a supplemental benefit, but no plan has to, so ask the plan in writing. For Medicaid, the state decides what counts as covered equipment, so ask the state Medicaid agency or your parent's plan how it handles grab bars and, if they aren't on its list, use the state's process for requesting items not on the list.

Learn More

CaregiverHow to Pay for Home Modifications for an Aging ParentHow to pay for home modifications: Original Medicare won't cover grab bars or a stair lift. See who can, from Medicaid waivers to USDA 504, and their rules. MedicareHow Medicare Covers Durable Medical EquipmentHow Medicare durable medical equipment coverage works in 2026: the 5 rules for DME, your 20% share when the supplier accepts assignment, and rent vs. buy. MedicaidHow to Appeal a Medicaid Denial: Your Fair Hearing RightsDenied Medicaid? You can appeal, and one deadline decides whether your benefits keep flowing during the appeal. Know your fair-hearing rights and act fast. CaregiverHome Safety and Fall Prevention for Aging Parents: A Caregiver's GuideFalls are the leading cause of injury death for adults 65+, and simple steps can help prevent them. The CDC steps, a home checklist, and who to call. MedicareWhat Medicare Doesn't Cover, Including Long-Term CareWhat Medicare doesn't cover, from long-term care to dental, vision, and hearing. Does Medicare cover long-term care? No, and here's where families turn instead.

Find personalized help asking Medicaid for bathroom safety equipment at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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