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What Medicare Covers for COPD

COPD (chronic obstructive pulmonary disease) affects more than 12 million Americans. Even more frightening, another 12 million Americans may have the disease without knowing it. According to the Centers for Disease Control and Prevention, COPD was the third-leading cause of death in the U.S. in 2014. COPD is a progressive disease, meaning it gets worse the longer you have it, so it’s important to know what Medicare will and won’t cover for it.

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 cause by other forms of smoking tobacco like that from pipes or cigars. Secondhand smoke, air pollution, chemical fumes, and dust can also contribute to the disease. There is currently no cure for COPD.

Treatments

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.

The first line of treatment for COPD is to quit smoking. Additional treatments may include medicine, pulmonary rehabilitation, and oxygen therapy.

  1. Medicine for COPD may include bronchodilators and inhaled steroids, both of which open the airway to help you breathe easier.
  2. Pulmonary rehabilitation helps you maintain normal daily activities by providing exercise, education, nutritional counseling, and psychological counseling.
  3. 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 session 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 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.

 

 

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