Why This Matters In 2025
Falls in the bathroom are a top cause of injury for older adults and people with limited mobility. A low-step shower, sturdy grab bars, and slip-resistant floors can make a huge difference. The big question is who pays for these upgrades. Below, we break down how Medicare, Medicaid, and other programs in Oregon and Washington may help, using plain language you can act on today.
Key Takeaways
- Original Medicare will not pay to rebuild or replace a bathtub or shower.
- Some Medicare Advantage plans may give a small home-safety benefit.
- Oregon Medicaid (Oregon Health Plan) can fund bathroom changes through its “K Plan” and related programs.
- Washington Medicaid (Apple Health) may cover a walk-in shower under the COPES or New Freedom waivers.
- Local grants, loans, and veteran programs can also bridge gaps.
- Clear medical proof of need is essential for any program.
- Bath Pros NW can provide free quotes for safe, code-compliant installs.
1. What Original Medicare Covers (and Doesn’t)
Original Medicare Parts A and B pay for hospital stays, doctor visits, and specific medical equipment. A new shower or walk-in tub is often viewed as a home upgrade, rather than medical equipment. That means:
- No coverage for demo, plumbing, or walls.
- Medicare may cover small items such as a portable commode or a shower chair if your doctor writes a prescription.
- Medicare will pay 80% of an in-home safety visit by a licensed therapist if ordered by your doctor. The therapist can recommend changes, but Medicare still will not fund the remodel itself.
Bottom line: expect to pay out of pocket unless you have other coverage.
2. When Medicare Advantage May Help
Private insurers sell Medicare Advantage (Part C) plans. Since 2019, the rules have allowed these plans to add “home safety” perks. In some Oregon or Washington counties, a plan may:
- Give a yearly allowance ($200–$2,000) to spend on grab bars or a step-through tub cut.
- Send a contractor out once per year to install selected safety items.
- Only a small share of plans offer this perk, so read the “Extra Benefits” section or call the plan before you enroll.
- A doctor’s note that says a safer shower is “medically necessary to prevent falls” boosts approval chances.
- Funds are often capped and may not cover complete demo-and-replace jobs.
3. Oregon Programs That Pay for Bathroom Safety
3.1 Oregon Health Plan (Medicaid) – “K Plan”
If you live in Oregon—including Multnomah County—and qualify for the Oregon Health Plan, you may be eligible for up to $5,000 or more in home modifications through the K Plan. This benefit helps seniors and people with disabilities stay safely in their homes. Covered changes can include:
- Roll-in or low-threshold showers
- Grab bars, handheld shower heads
- Raised toilets and widened doorways
Live in Portland, Gresham, or surrounding areas? These benefits apply in Multnomah County and are coordinated through your local Area Agency on Aging.
To get started in Multnomah County or nearby areas:
- Call the Aging and Disability Resource Connection of Oregon (ADRC) at 1-855-ORE-ADRC.
- Request a home safety and care needs assessment.
- Ask if your Medicaid care plan can include a bathroom remodel or conversion.
3.2 Oregon Project Independence (OPI & OPI-M)
- OPI helps Oregonians aged 60 and older who are not on Medicaid but need some assistance.
- OPI-M provides similar assistance to certain Medicaid members who have not yet reached the level of nursing-home care.
- Tub-to-shower inserts
- Non-slip floors or seating
- Grab bars and railings
Both programs may fund minor safety upgrades, such as tub cuts or handheld shower heads. Contact your local Area Agency on Aging (AAA) to check waitlist availability and income eligibility requirements.
4. Washington Programs That Pay for Bathroom Safety
4.1 COPES Waiver (Apple Health Medicaid)
If you live in Clark County, Cowlitz County, or anywhere in Southwest Washington, the COPES waiver is your best Medicaid option for home safety changes. This includes full or partial funding for:
- Walk-in or roll-in showers
- Widened bathroom access
- Safety upgrades to prevent falls
To apply in or find out more about the available coverage for Clark or Cowlitz County:
- Contact the Area Agency on Aging & Disabilities of Southwest Washington (AAADSW) at 360‑735‑5720
- Ask for a COPES eligibility screening and home safety assessment
- A case manager will determine what upgrades are medically necessary
4.2 New Freedom Waiver – Not Available in Clark County
The New Freedom Waiver, a flexible self-directed care option, is only available in King and Pierce Counties. If you’re in Clark or Cowlitz County, this waiver isn’t offered, but COPES covers many of the same services and is widely available.
5. Other Helpful Resources
| Program / Resource | Who It Helps | What It Can Fund | Where to Apply |
|---|---|---|---|
| Veterans Affairs HISA / SAH Grants | Qualified veterans | Roll-in showers, grab bars | Local VA medical center |
| USDA Rural Housing Repair Grants | Low-income rural homeowners 62+ | Health and safety home repairs up to $10k | Local USDA field office |
| Habitat for Humanity or Rebuilding Together | Very-low-income seniors | Volunteer or sliding-scale home fixes | Local chapter websites |
| City / County Minor Home Repair | Varies by location | Small safety jobs, sometimes bath conversions | City housing or senior services offices |
| 2-1-1 Info Line | General public | Referral to nearest assistance programs | Call 2-1-1 from any phone |
6. How to Boost Your Approval Odds
- Get medical proof. Ask your doctor or physical therapist for a letter that says a low-step shower is “medically necessary to prevent falls.”
- Use the program’s contractor list. Medicaid and many grants require licensed, vetted installers.
- Apply early. Waiver slots and grant funds are limited and can run out each budget year.
- Keep receipts and pictures. You may need them for reimbursement or tax deductions.
7. Why Choose Bath Pros NW
We specialize in safe and stylish shower replacements throughout the Portland-Vancouver metro area. When you work with us, we will:
- Offer a complimentary in-home assessment to identify the ideal safety features.
- Supply a clear, itemized quote that you can include with Medicaid or grant paperwork.
- Install ADA-style, acrylic showers in as little as one to two days, backed by a lifetime warranty.
Have Questions? Call Bath Pros NW at (360) 693-2284 or contact us to schedule your consultation.
8. Quick Start Checklist
1. Confirm Eligibility
- Medicare Advantage plan? Review your Extra Benefits booklet.
- Medicaid? Call ADRC Oregon (1‑855‑673‑2372) or ALTSA Washington (1‑800‑422‑3263).
2. Collect Documents
- Doctor’s letter + any therapy notes
- Proof of income (for Medicaid/grants)
- Bath Pros NW written quote
4. Submit and Follow Up
- Request written approval before commencing work.
- Keep the case manager’s number handy.
5. Book Installation
- Once approved, set a date with Bath Pros NW.
- We handle permits and haul away debris.
9. Final Word
A safer bathroom is not a luxury—it is a necessity for healthy aging. While Original Medicare does not cover a full shower remodel, seniors in Washington and Oregon have real options through Medicare Advantage, Medicaid waivers, and community grants. Partnering with an experienced remodeler like Bath Pros NW makes the process easier.
Ready to take the first step toward a safer, more comfortable bath? Contact Bath Pros NW today—it could be the most important call you make this year.
Sources & References
- Oregon Health Plan K Plan Guidelines (https://www.oregon.gov/dhs)
- Washington DSHS COPES Waiver (https://www.dshs.wa.gov/altsa)
- CMS Medicare Advantage Extra Benefits Memo (https://www.cms.gov)
