Medicare & Pulmonary Rehabilitation Programs

Chronic obstructive pulmonary disease, or COPD, is a scary diagnosis. It can mean a significant reduction in your quality of life, and there is unfortunately no cure for the condition. But there is some hope: elderly people who partake in pulmonary rehabilitation programs can see a significantly improved quality of life. The rehab program will not cure any lung disease, but it will help with breathing problems and give you more strength. Does Medicare cover pulmonary rehabilitation programs, and if so, what are the requirements?image of a glass lung with a tree growing in the lungs with the article title

What Is Pulmonary Rehabilitation?

Pulmonary rehabilitation is a nonpharmacologic treatment program targeting the symptoms of COPD. It’s a broad-based, outpatient program that provides exercises, peer support, and education for people who need it. 

 

You can access pulmonary rehab services in your doctor’s office, a clinic, or in a hospital outpatient facility. During pulmonary rehabilitation, you will learn more about COPD, lung function, and exercises that can help you gain strength and breathe more efficiently. As we stated above, it can help improve your quality of life, even if it can’t cure your COPD.

Medicare Part B Coverageillustration of a lung ontop of a blue circle

Medicare Part B, medical insurance, covers a comprehensive pulmonary rehabilitation program if: 

  • You have moderate to severe COPD
  • Your doctor gives you a referral for COPD treatment
  • You had a confirmed or suspected case of Covid-19 and have persistent systems, including respiratory dysfunction, for at least four weeks.  

 

Medicare will typically cover up to 36 pulmonary rehab sessions. Your doctor can request a coverage be increase to 72 sessions if it is medically necessary.

How Much You Will Pay?

When it comes to your out-of-pocket costs for a pulmonary rehab program, you will first have to meet your annual Medicare Part B deductible. As well as pay your Medicare Part B monthly premiums. Once you have met your Part B deductible, you will be responsible for 20% of the Medicare-approved cost of your pulmonary rehabilitation services. If you receive the treatment at a doctor’s office, you will pay 20% of the Medicare-approved amount. If you get treated in a hospital outpatient setting, you will pay the hospital copay per session. 

Extra Coverage

If the 20% coinsurance that you will be required to pay for pulmonary rehab seems daunting, know that a Medicare Supplement Plan can cover some of the out-of-pocket costs that Original Medicare does not cover. These plans can help keep out-of-pocket expenses down, especially if you have a chronic condition such as COPD. 

 

There are 10 different Medicare Supplement Plans to choose from, each offering different coverage options and rates. It’s worth looking into a Medicare Supplement Plan to save as much money as you can. So speak to an EZ agent for all of your options. EZ’s agents work with the top-rated insurance companies in the nation and can compare plans in minutes for you at no cost. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side. Or to speak to a licensed agent, call 888-753-7207.

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. 

pink piggy bank
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. 

This Household Vitamin Could Be The Key To Reducing COPD Attacks

Chronic obstructive pulmonary disease, COPD, is common with almost 12 million people in the U.S. diagnosed every year. Of those adults who are diagnosed, about 120,000 die from it annually. COPD includes a combination of lung conditions that make it hard to breathe, such as chronic bronchitis, and emphysema. According to a new study, people with COPD, are more likely to have an exacerbation if they are deficient in vitamin D

How It Is Deadly

Internal look of lungs.
COPD includes a combination of lung conditions that make it hard to breathe, such as chronic bronchitis, and emphysema.

COPD affects a person’s lungs and their ability to breathe. When symptoms get worse, often unexpectedly, a lung attack can occur. These lung attacks can create an upper respiratory infection. As symptoms worsen, the likelihood of death is increased substantially. 

Reducing Death

The deadly lung attacks might be averted by a daily dose of vitamin D. Adrian Martineau, Ph.D., clinical professor of Respiratory Infection and immunity at the Queen Mary University of London, led a study and analyzed data from 469 patients with COPD from 3 clinical trials. He focused on a number of people taking vitamin D doses daily. His findings were that higher levels of vitamin D in patients had a 45% reduction in lung attacks than those who were deficient in vitamin D. 

Dr. Martineau said, “Our study shows that giving supplements to vitamin D-deficient COPD patients nearly halves their rate of potentially fatal attacks.” And that “Vitamin D supplementation is safe, and it costs just a few pence to supplement a person for a year—so this is a potentially highly cost-effective treatment that could be targeted at those who have low vitamin D levels following routine testing.”

How Much Vitamin D?

Researchers from the study provided the COPD patients with oral vitamin D3 doses varying from 220,000 IU in six months to 1.2 million IU in 12. What this means is that you should keep your vitamin D levels above 30-40 ng/mL (nanograms per milliliter), and in order to do this, 1000-5000 IU of vitamin D3 is needed a day. 

Cooked salmon laying on a bed of tomatoes with mushrooms and cheese on top.
Vitamin D can be found in foods such as salmon. mushrooms, fish, and more.

Vitamin D supplements can be found in your local grocery store, and in pharmacies. Food is also a great way to get the vitamin D your body needs. Your diet should include salmon, sardines, canned tuna, shrimp, egg yolks, mushrooms, oatmeal, and milk. These foods are high in vitamin D and offer more nutrients for your body. If you cannot get out in the sun to soak up your 10-30 minute daily dose of vitamin D, then supplements and your diet are great ways to get this essential nutrient.

The clinical trials conducted by the researchers offered great insight as to how to reduce a lung attack from COPD.  Soon, another clinical trial will be conducted in order to fully understand the effects of vitamin D on people with COPD. Vitamin D has been found to offer protection against asthma attacks, the flu, and more. It might not be a miracle vitamin, but it does offer many benefits, and will not cause harm to your body. If you suffer from COPD, vitamin D might just be what you need to reduce the chances of a lung attack, and possibly save your life.