Medicare Coverage & COPD: Everything You Need To Know

Currently, more than 25 million people in the United States have asthma. Approximately 14.8 million adults have been diagnosed with COPD, and approximately 12 million people have not yet been diagnosed. The burden of respiratory diseases affects individuals and their families, schools, workplaces, neighborhoods, cities, and states. Because of the cost to the health care system, the burden of respiratory diseases also falls on society. It is paid for with tax dollars, higher health insurance rates, and lost productivity. Annual health care expenditures for asthma are at an estimated $20.7 billion.

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a group of diseases that cause breathing problems, like emphysema, chronic bronchitis, and asthma. People with COPD are more likely to have difficulty walking or climbing stairs, be unable to work, and have other chronic diseases, such as diabetes or heart disease. Testing for COPD helps detect the disease early and treat the symptoms as soon as possible.

Symptoms

Symptoms of COPD may start off subtle and be easily overlooked. Catching the disease early is crucial to managing the symptoms before they progress. Some of the symptoms are:

• Ongoing cough
• Shortness of breath
• Wheezing
• Chest tightness

Causes

COPD is primarily caused by smoking cigarettes. It can also be caused by other forms of smoking tobacco like pipes or cigars. Secondhand smoke, air pollution, chemical fumes, and dust can also contribute to the disease. There is currently no cure for COPD. Damage to the lungs from COPD can not be reversed.

Treatments options

Severe COPD can interfere with basic activities like walking and housework, making it hard to manage day-to-day life. However, it can sometimes be managed through treatments and lifestyle changes.

1. The first line of treatment for COPD is to quit smoking.
2. Additional treatments may include medicine, pulmonary rehabilitation, and oxygen therapy. Medicine for COPD may include bronchodilators and inhaled steroids, both of which open the airway to help you breathe easier.
3. Pulmonary rehabilitation helps you maintain normal daily activities by providing exercise, education, nutritional counseling, and psychological counseling.
4. Oxygen therapy may be used to treat severe cases of COPD and can be used all the time or some of the time, depending on the needs of the patient.

What Medicare covers for COPD

Medicare covers many treatments and medications to help with symptoms of COPD. For services and items covered under Part B, Medicare beneficiaries will be responsible for 20 percent coinsurance after the Part B deductible has been met. The coverage of any services or items to treat COPD depends upon the severity of the disease and can vary by patient.

Medicare Part B may cover:

• Up to 8 face-to-face counseling sessions within a 12-month period
• Smoking cessation aids like nicotine patches
• Pulmonary rehabilitation: up to 2 one-hour sessions per day up to 36-lifetime sessions
• Oxygen therapy: oxygen therapy supplies and rental equipment as durable medical equipment (DME)

Medicare Part D may cover:

• Bronchodilators and inhaled steroids
• Other medications used for the treatment of symptoms

If you find yourself unable to pay for your COPD treatments and medication, ask your doctor if there are cheaper generic alternatives available to you. If not, ask your doctor for samples.

Prevention

Unlike some diseases, COPD typically has a clear cause and a clear path of prevention, and there are ways to slow the progression of the disease. The majority of cases are directly related to cigarette smoking, and the best way to prevent COPD is to never smoke — or to stop smoking now.

Living with COPD?

Here are some steps you can take to help prevent complications associated with COPD:

• Quit smoking to help reduce your risk of heart disease and lung cancer.
• Get an annual flu vaccination and regular vaccination against pneumococcal pneumonia to reduce your risk of or prevent some infections.
• Talk to your doctor if you are experiencing any feelings of sadness, helplessness, or think that you may be experiencing depression.