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.