People stop looking after Medicare says no. That is the beginning of the list rather than the end of it.
We are not accountants or benefits advisers. This is what we see work, and every one of these needs checking with somebody qualified.
1. Medical expense deduction
Home modifications made for a medical reason can sometimes be treated as a deductible medical expense, to the extent they do not increase the value of the property.
That last clause matters. A stairlift generally adds nothing to a home’s value, which tends to help rather than hurt here. A bathroom remodel is a different conversation.
Keep the physician’s letter, the itemized invoice and the scope of work. Ask a tax professional before assuming anything.
2. Medicaid waivers
The route most often missed entirely. State Medicaid programs run Home and Community-Based Services waivers designed to keep people in their homes rather than in institutional care, and home modifications are frequently within scope.
Coverage, amounts and waiting lists vary enormously by state. Start at Medicaid.gov and then call your state Medicaid office or Area Agency on Aging.
These often have waiting lists measured in months, which is the argument for starting the application before you need the equipment.
3. Area Agencies on Aging
Every region has one, most families have never heard of them, and they hold or know about small grant programs, volunteer labor schemes and loan closets for equipment.
One phone call. It is the highest-value call on this page.
4. The VA
HISA, SAH and SHA for the home, and automobile adaptive equipment for the vehicle. We are a federal contractor and approved vendor and we still cannot tell you what will be approved. Our VA guide sets out how it reaches us and how to request a provider by name.
5. Workers compensation and settlements
If the disability arose from a work injury or an accident with a liability claim, home and vehicle modification is frequently within scope and frequently forgotten during the settlement.
Raise it with the attorney before a settlement is finalized rather than afterward.
6. Long-term care insurance
Some policies include home modification benefits. Read the policy rather than assume, and ask specifically.
What Medicare will and will not do
Portable equipment can fall inside durable medical equipment: wheelchairs, walkers, rollators, hospital beds, patient lifts. Anything fixed to the building generally does not, which is why a hospital bed is covered and the grab bar beside it is not.
Some Medicare Advantage plans have added supplemental home-modification benefits. That varies by insurer, plan and year, and it is the one route where the answer might be yes. Call the number on your card and ask for it in writing.
The routes that cost nothing to explore
Doing the cheap things first, which is usually lighting, rugs and a grab bar. Our aging in place guide covers the order.
And plenty of what helps simply ships free from our online shop without a determination from anybody.
Loan closets and reuse programs
Many communities run equipment reuse schemes: donated wheelchairs, rollators, commodes and bath seats, cleaned and loaned free or for very little.
An Area Agency on Aging, a local independent living center or a faith community usually knows where the nearest one is. For a short-term need this beats buying.
It is also where to take equipment you no longer need, which is a better outcome than a garage.
Non-profits and disease-specific organizations
Organizations focused on a particular condition frequently run small equipment grants that nobody outside that community hears about. If a diagnosis is attached to the need, that is a call worth making.
Start before you need it
The single most useful thing on this page. Waiver waiting lists, grant cycles and VA determinations all run in months rather than weeks.
Families who start looking at the point of crisis pay full price because they cannot wait. Our buying checklist is worth having ready before that moment arrives.
Keep every document
Physician letters, itemized invoices, the written scope of work, photographs before and after, and any determination letter. Several of these routes require documentation you cannot recreate afterward.
It is dull advice and it is the difference between a claim that succeeds and one that stalls. We provide itemized scopes as a matter of course, whether or not you are claiming anything.
Ask us to write it properly
A scope written in the language a program expects is worth more than the same job described loosely. We will do that at no charge, and it carries no obligation to use us for the work.
Who to call first
The Area Agency on Aging for your region. One call, no eligibility test to get information, and they hold or know about most of what is on this page for your specific area.
If you make only one call after reading this, make that one.