Medicare & COPD

Chronic obstructive pulmonary disease, or COPD, is most common among individuals 65 and older. It is especially common among women age 65 to 74 years old. This disease is the third leading cause of death in the United States, and anyone with COPD has a significantly increased risk of severe illness or death from complications from the flu or respiratory illnesses like COVID-19. 

When it comes to those suffering from COPD, life expectancy is determined by multiple factors such as history of smoking, and other conditions that might add further complications. While most patients with COPD can live with the disease for many years, they will need to constantly manage and treat this chronic condition. For older Americans, this continuous management can be costly, but fortunately, Medicare covers screenings and treatment up to a certain point.

What Is COPD?torso of a man with the lungs shown through with the red veins/tissue

For the over 30 million Americans who are living with COPD, every day can mean a struggle to breathe. COPD, a group of progressive lung diseases, such as emphysema, slowly destroys air sacs in the lung, causing air flow blockage and breathing-related problems. The disease develops over  a long time, and the most common cause of it is smoking tobacco.

Because the disease is progressive, there is unfortunately no cure for COPD. However, treatments can help ease the symptoms and lower the chances of complications, while improving quality of life. If not treated, COPD can cause heart problems and worsening respiratory infection.

COPD Symptoms

caucasian woman with short blonde hair holding her chest with one hand.
Some COPD symptoms include shortness of breath and tightness in the chest.

The symptoms of COPD come in stages. Early symptoms include occasional shortness of breath, a mild recurrent cough, and a frequent need to clear the throat. But if the symptoms are not treated, they can get progressively worse. Worsening symptoms include:

  • Shortness of breath with little exertion, such as from going up a flight of stairs
  • Tightness in the chest 
  • Wheezing
  • Frequent colds, flu, or other respiratory infections
  • Chronic cough
  • Lack of energy

In the later stages of the disease, symptoms include weight loss, and swelling of the feet, ankles, or legs. If you are suffering from COPD, it is important to seek immediate medical care if you have trouble catching your breath, feel confused or faint, or have bluish or gray fingernails or lips.

Medicare COPD Coverage

There is no single test for COPD. Diagnosis is based on assessing the symptoms mentioned earlier, a physical exam, and diagnostic test results. To help diagnose you, Medicare Part B will cover a lung cancer screening with Low Dose Computed Tomography (LDCT). Medicare will cover this screening once a year if you:

  • Are 55 to 77 years old
  • Have a history of smoking at least 1 pack of cigarettes a day for 30 years
  • Are a current smoker or have quit smoking in the last 15 years
  • Are asymptomatic (don’t have signs or symptoms) of lung cancer
  • Get a written order from your doctor

As long as you meet all of the above criteria and your doctor accepts Medicare assignment,  Medicare Part B will cover 100% of the screening.

If you have already been diagnosed with COPD,  Medicare Part B will cover a pulmonary rehabilitation program to help manage your COPD. This program should help you breathe better and improve your quality of life. Medicare Part B will completely cover the pulmonary rehabilitation program as long as you have a referral from your doctor. 

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Medicare Supplement Plans will help pay for the 20% Medicare does not cover, which will help you save more money.

Getting More Coverage

Other expenses related to COPD treatment and management might only be covered 80% by Medicare, leaving you with 20% coinsurance to pay out-of-pocket. But you can save money on these expenses with a Medicare Supplement Plan, which will pay your 20% coinsurance for  COPD coverage, as well as all other Medicare-covered conditions. 

It can be overwhelming  to review your options and go over all 10 different Medicare Supplement Plans, but that is what EZ.Insure is here for. EZ’s dedicated agent will compare all available plans in your area and review all of your options. We will provide you with quotes for free, and find a plan that fits your needs and budget, while helping you save hundreds of dollars a year. To get free instant quotes, simply enter your zip code in the bar above, or to speak directly with one of our agents, call 888-753-7207. 

About The Author:
Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.

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