- Falls are a leading reason older adults move into nursing homes, and many falls can be prevented (CDC).
- More than 95% of hip fractures in older adults are caused by falls (CDC), and a hip fracture can mean a long, difficult recovery.
- Medicare can cover fall-risk screens, balance physical therapy, medication reviews, and, when medically necessary with a doctor's order, mobility equipment like canes, walkers, and wheelchairs. Some Medicare Advantage plans also cover grab bars and shower seats.
- A Careway Advocate can help arrange a home safety check, book PT your doctor orders, set up a medication review, and explain what your plan covers, so staying home is more likely.
Careway Advocates are dedicated care navigators who help people find and apply for Medicare and community benefits they may qualify for. Advocacy is covered by Medicare for people who qualify.
7 ways to lower fall risk at home.
Make the bathroom safer.
The bathroom is one of the most common places to fall: wet floors, low toilets, no grip on the way in and out of the shower. Three things change the odds: grab bars by the toilet and inside the shower, a non-slip mat, and a shower seat. None of these are exotic; they're the first things any home safety assessment recommends.
Light the path you walk at night.
A surprising share of senior falls happen in the dark: the path from the bedroom to the bathroom, hallway corners, the top of the stairs. Plug-in night-lights, motion-sensor LEDs, and a bedside lamp you can reach without standing up are cheap, immediate fixes that quietly cut your fall risk every night.
Clear your floors. Check your shoes.
Loose throw rugs, exposed cords, low coffee tables, pets underfoot: the trip hazards in your home are mostly invisible to you because you've lived with them for years. Backless slippers and worn-out soles are quietly some of the worst offenders. Replacing a single pair of slippers with non-slip house shoes is one of the cheapest fall-prevention moves you can make.
Use the fall-risk screen Medicare covers in the yearly wellness visit.
Medicare's Annual Wellness Visit is a yearly prevention visit with no cost when the provider accepts assignment, and it includes a review of fall risk and home safety. It is not a full physical exam, and many people never schedule it. If a doctor finds a risk, they may order physical therapy, a vision check, or a medication review.
Review every medication you take.
Falls spike right after a new prescription, especially sleep aids, blood-pressure pills, sedatives, anti-anxiety medications, and some pain relievers. Many older adults take several medications, and the interactions between them are easy to miss. Many Part D plans offer Medication Therapy Management (MTM), a pharmacist review at no extra cost for members who meet the plan's criteria, such as having multiple chronic conditions and medications.
Get strength-and-balance physical therapy.
The single most-studied fall-prevention intervention is structured strength-and-balance training. Exercise programs like Otago and tai chi have been shown to lower fall rates by about a quarter or more in studies (Cochrane review). Medicare covers physical therapy when it's medically necessary and a doctor orders it, and some Medicare Advantage plans include a fitness benefit with group classes. A PT visit also typically includes a check on whether a cane, walker, or other mobility aid would steady you, and if so the PT can recommend one to your doctor.
A dedicated Careway Advocate who can help coordinate the other six.
The first six on this list all exist, but someone has to make them happen: book the Annual Wellness Visit, check for a covered grab-bar benefit, schedule the medication review, ask your doctor about PT, and arrange the ride. A Careway Advocate can help coordinate those steps. Advocacy is covered by Medicare for people who qualify.
Why preventing falls matters.
About 28% of older adults (roughly 14 million people in the US) fall every year. Most falls don't kill anyone outright. What they do is start a cascade: a fall causes an injury, the injury causes a hospital stay, the hospital stay leaves you weaker than you arrived, and rehab or "just a few weeks" of assisted living quietly becomes permanent. By the time most families realize what's happening, the fall has already decided where the next chapter happens.
- Falls are common and can be serious
- Roughly 39,000 older adults died from a fall in 2021 (CDC). Each year there are about 3 million ER visits and 1 million hospitalizations for senior falls. Falls are the leading cause of both fatal and non-fatal injury for adults 65+.
- Hip fractures are the worst-case
- More than 95% of hip fractures in older adults are caused by falls (CDC). Recovery can be long, and many people need more help afterward than they did before.
- The path from fall to facility is short
- Research has linked falls and unsteadiness to a large share of nursing-home admissions (NEJM, 1997). A fall doesn't have to be the final fall to end home. It just has to be the one that triggers the next decision.
- Cost comparison
- The national median for assisted living is around $5,350/month (over $64,000 a year). Nursing home (private room) is closer to $9,700/month. Aging at home with Medicare-covered support and community programs often costs far less. Many patients pay little to nothing out of pocket because Medigap or Medicaid covers their coinsurance.
The reason many seniors end up in a facility after a fall isn't that prevention is impossible. It's that prevention is fragmented across a half-dozen Medicare benefits, plan riders, and community programs that nobody walks you through. That's the gap your Advocate fills.
Medicare benefits many people miss.
Medicare can cover many fall-prevention services for people who qualify. The catch is that the benefits live in different parts of the program, and no one calls to tell you they exist.
Under Original Medicare
- Annual Wellness Visit — Yearly prevention visit, no cost when your provider accepts assignment. Includes a fall-risk review and home-safety questions. It is not a full physical exam.
- Physical therapy for balance and strength — When medically necessary and ordered by a doctor, Part B covers 80% after the deductible. Medigap or Medicaid may cover the remaining 20%.
- Home health (if you're homebound) — PT, OT, nursing, and home health aide services delivered in your home. No copay for most home health services.
- Medication Therapy Management (MTM) — Free in-depth pharmacist review for Part D enrollees with multiple chronic conditions or multiple medications. Especially valuable for catching fall-causing drug interactions.
- Bone density screening — Covered every 24 months (more often if medically necessary) for people who meet Medicare's risk criteria, such as women at risk for osteoporosis. It can help find osteoporosis before a fracture.
- Glaucoma tests — Covered once a year for people at high risk, such as those with diabetes or a family history of glaucoma. Poor vision is a known fall risk factor.
- Mobility equipment — Canes, walkers, rollators, wheelchairs, and scooters can be covered under Part B when medically necessary for use in the home, ordered by a doctor, and supplied by a Medicare-enrolled supplier. Part B pays 80% after the deductible; Medigap or Medicaid may cover the rest. Power chairs and scooters have stricter requirements. For the full coverage walkthrough, see our deeper guide: Will Medicare pay for a mobility scooter?
- Other durable medical equipment — Hospital beds, commodes, oxygen, and similar equipment can be covered under Part B at 80% after the deductible when medically necessary. Raised toilet seats are generally not covered. Note: grab bars and shower seats are not generally covered under Original Medicare alone. See the Medicare Advantage section below.
If you're on Medicare Advantage
Some Medicare Advantage plans cover grab bars, shower seats, and other home-safety equipment, sometimes only for members with certain chronic conditions. Many plans also include a fitness benefit with balance classes. Coverage varies widely, and the details are in each plan's Evidence of Coverage.
Today, home-safety equipment like grab bars and shower seats is covered mainly through some Medicare Advantage plans and Medicaid programs, not Original Medicare.
Community benefits beyond Medicare.
Outside of Medicare there's a quiet parallel system of state, federal, and local programs built specifically to keep older adults at home. Most of them never reach the people they're built for.
- Medicaid HCBS waivers
- State Medicaid programs that pay for home modifications (ramps, grab bars, accessible showers, widened doorways) specifically to keep people out of nursing homes. Eligibility varies by state, but the programs exist in every state. Personal care and respite for family caregivers are usually included.
- Area Agencies on Aging (AAA)
- Over 600 local agencies that arrange free home-safety assessments, benefits counseling, and equipment loans. The federal Eldercare Locator (eldercare.acl.gov or 1-800-677-1116) points you to yours.
- CDC STEADI program
- "Stopping Elderly Accidents, Deaths & Injuries", the CDC's evidence-based protocol for fall risk. Increasingly used by primary care doctors who've been trained on it. If your doctor hasn't, you can ask them to use it, or your Advocate can help you find a provider who does.
- Falls-prevention classes
- Programs like Stay Active and Independent for Life (SAIL), Tai Chi for Arthritis, and Stepping On are run by AAAs, YMCAs, and senior centers across the country. Most are free or sliding-scale. Several have been shown to cut fall rates significantly.
- Loan closets
- Local nonprofits (Lions Clubs, Salvation Army, hospitals, AAAs) loan out walkers, wheelchairs, shower benches, and other equipment for free or by donation. Especially helpful while you wait on a Medicare-covered order.
- VA Aid & Attendance
- For veterans and surviving spouses who need help with daily activities. An additional monthly pension on top of basic VA pension, usable for in-home care, home modifications, or assisted living if needed.
Why these benefits get missed.
Fall-prevention benefits aren't denied to people. They're left on the table, because no one whose job it is to find them ever calls.
- The Annual Wellness Visit gets treated as a checkbox by busy primary care offices. The fall-risk screen built into it often doesn't happen unless you ask for it by name.
- Doctors don't always ask about near-falls. Patients don't always report them. Many seniors are afraid that admitting to a fall will trigger a conversation about leaving home.
- The connection between a new prescription and a new fall risk is easy for patients to miss. The pharmacist who could spot it is rarely the same person who prescribed it.
- Medicare Advantage home-safety benefits are often buried deep in a plan's coverage documents, so some members have a benefit and never know it.
- Many families only look for fall-prevention help after a fall, when the conversation has already shifted to rehab.
Your Careway Advocate's job is to help with this work early: find benefits you may qualify for, schedule the care, and help with the paperwork.
Frequently asked questions
Get a post-fall assessment with your doctor this week. Falls predict more falls, and your risk of falling again roughly doubles after the first one. The faster you get the medication review, the PT, and the home assessment done, the more likely the second fall doesn't happen.
It depends on your plan. Original Medicare alone does not generally cover them. Some Medicare Advantage plans do, and Medicaid HCBS waivers may cover home modifications for eligible people. Your Advocate can check your plan and explain what it covers.
Often, yes. Many local Area Agencies on Aging (find yours at eldercare.acl.gov) offer home-safety checks at low or no cost, the Annual Wellness Visit includes home-safety questions, and an occupational therapy visit may be covered if your doctor orders it.
The evidence is unusually strong for an intervention. Structured strength-and-balance programs (Otago, tai chi, and similar) have been shown in studies to lower fall rates by about a quarter or more (Cochrane review). The hard part is starting and sticking with one. Medicare covers PT when prescribed, and Medicare Advantage often includes free gym/balance classes through SilverSneakers.
Yes, fall risk climbs noticeably with the number of medications, especially sleep aids, sedatives, blood-pressure medications, and some pain relievers. Ask your Part D plan whether you're eligible for a Medication Therapy Management review with a pharmacist; it's offered at no extra cost to members who meet the plan's criteria. Your Advocate can book it and help you walk through every pill bottle with the pharmacist.
Run the medication list. Falls climb most sharply right after a new prescription, and the interactions between drugs are almost never reviewed end-to-end. If you do nothing else, get a pharmacist to look at every bottle (including over-the-counter sleep aids and antihistamines) and flag the high-risk combinations. Then schedule the Annual Wellness Visit if it hasn't happened this year.
For people who qualify, yes. Careway's advocacy is covered by Medicare as a Part B service, so the Part B deductible and 20% coinsurance may apply. Many patients pay little to nothing out of pocket because Medigap or Medicaid covers their coinsurance. We'll go over what you may owe before you start.
The bottom line.
Many seniors who end up in assisted living after a fall didn't fail at staying home. They were never told what their Medicare actually covers. Fall-risk screens, balance physical therapy, medication reviews, home health, and medical equipment can be covered when Medicare's requirements are met, and some Medicare Advantage plans cover home-safety equipment. The community programs that fill the rest exist in every state.
The hard part is finding the benefits, scheduling the care, and filing the paperwork. A Careway Advocate can help you put the plan in place, so you can focus on staying safe at home.
- CDC. Facts About Falls — Older Adult Fall Prevention
- NEJM. Falls, Injuries Due to Falls, and the Risk of Admission to a Nursing Home
- Medicare.gov. Yearly "Wellness" visits
- Medicare.gov. Physical therapy coverage
- AARP. Does Medicare Cover Home Safety Equipment?
- Aging in Place Directory. Does Medicare Cover Grab Bars in 2025?
- Administration for Community Living. Eldercare Locator (Area Agencies on Aging)
- Medicaid.gov. Home and Community-Based Services