Does Medicare Cover COPD senior woman using inhaler

Does Medicare cover COPD?

Does Medicare cover COPD - senior coughing
Chronic cough is a symptom of COPD.

Medicare does cover Chronic Obstructive Pulmonary Disease (COPD). Part B covers COPD treatment services such as counseling to quit smoking, oxygen equipment, and pulmonary rehabilitation programs. Part D covers COPD prescriptions such as bronchodilators and steroid inhalers. Read this article to learn more about COPD, including:

What is COPD?

Chronic Obstructive Pulmonary Disease (COPD), according to the Mayo Clinic, “is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.” The American Lung Association says, “COPD is the third leading cause of death by disease in the United States.” Furthermore, “More than 16.4 million people have been diagnosed with COPD,” and millions more may have COPD and not know it.

There is no cure for COPD. However, the disease is preventable and treatable. Find out what causes COPD and the preventative actions you can take.

Does Medicare cover COPD normal vs inflamed bronchial tubes

What Causes COPD?

Does Medicare cover COPD - senior man smoking cigarette
Smoking is the main cause of COPD.

The American Lung Association says cigarette smoking causes 85 to 90 percent of all COPD cases. Furthermore, what you breathe every day at work, home, and outside can cause chronic inflammatory lung disease. For example, secondhand smoke, dust, fumes, and chemicals can cause COPD. 

In rare cases, a genetic condition called Alpha-1 deficiency-related emphysema causes COPD. MedlinePlus says this inherited disorder has a SERPINA1 gene mutation that leads to a shortage or abnormal form of alpha-1 protein. Consequently, the deficiency of alpha-1 protein destroys the alveoli in your lungs.

Now that you know what causes COPD, what can you do to prevent it?

3 Steps to Reduce Your Risk of COPD

You can take the following preventative steps to reduce your risk of COPD:

  1. If you are a smoker, STOP SMOKING. Medicare Part B covers up to 8 counseling visits every 12 months to help you quit smoking. You pay nothing for tobacco cessation counseling as long as your health care provider accepts Medicare assignment. 
  2. If you don’t smoke, don’t start. Smoking causes COPD, lung cancer, and other diseases. Medicare covers a free lung cancer screening every 12 months
  3. Avoid breathing secondhand smoke, dust, fumes, and chemicals. For example, you can wear a cloth mask over your nose and mouth to filter environmental particles. 

If you already have COPD, Medicare does cover the following treatment services.

Doctor consults with senior woman.

Medicare covers COPD Treatment

Does Medicare Cover COPD senior rehab walking on treadmill
Senior in Pulmonary Rehab walks on treadmill.

When you have moderate or severe COPD, Medicare Part B covers a Pulmonary Rehabilitation Program. According to Medicare.gov, this program helps you “breathe better, get stronger, and be able to live more independently.” So what does this program cost?

Pulmonary Rehabilitation Program Costs

Before Medicare Part B covers 80% of your program costs, you must first pay your Part B deductible. Then you pay 20% of the Medicare-approved amount when you get medical treatment in a doctor’s office. Moreover, in a hospital outpatient setting, you pay the hospital a copayment for each session.  

However, you can avoid paying 20% and hospital copays when you have Medigap Plan G. Senior Healthcare Direct can find you the most cost-effective Medicare Supplement Plan. Call 1-855-368-4717 or get your quote

Medicare also covers oxygen equipment in your home.

Oxygen Equipment for COPD

Furthermore, Part B covers the rental of oxygen equipment and accessories. Your doctor can prescribe this Durable Medical Equipment for use in your home. Medicare will pay for oxygen equipment under the following conditions:

  • You have a severe lung disease, such as COPD, or you are not getting enough oxygen.
  • Supplemental oxygen, aka oxygen therapy, might improve your health.
  • Your arterial blood gas has a low oxygen level.
  • Other alternative measures have failed.

When you meet the above conditions, Medicare covers the following oxygen equipment:

  • Systems that provide oxygen
  • Containers that store oxygen
  • Tubing and related oxygen accessories

So what does this Oxygen equipment cost?

Senior man supplemental oxygen for COPD

Oxygen Equipment Costs

After paying the annual Part B deductible, you pay 20% of Medicare-approved costs for oxygen equipment. A supplier will rent you oxygen equipment for 36 months. Then, as long as you have a medical need for oxygen, the supplier must provide you an additional 24 months. Furthermore, your monthly rental payments to the supplier cover the following: tubing or a mouthpiece, oxygen, and machine maintenance, servicing, and repairs.

To help you breathe easier, Medicare Part D covers COPD prescriptions.

Medicare covers COPD Prescriptions

Does Medicare Cover COPD senior woman using inhaler

Medicare Part D covers bronchodilators and steroid inhalers to treat COPD symptoms. According to Mayo Clinic, bronchodilators prescribed for COPD “relax the muscles around your airways so you can breathe better.” The prescription typically comes as inhalers and are available in two types: short-acting for quick relief and long-acting for maintenance therapy.

Some people who use bronchodilators may have “flare-ups” and require the use of antibiotics or steroids. For example, inhaled corticosteroids can help reduce the worsening of COPD symptoms (exacerbations).

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