COPD is a chronic respiratory disorder that affects more than 14 million Americans. Fortunately, Medicare-coverage for COPD is available for people with this crippling condition. These treatments can help suppress the symptoms and improve the quality of life of those suffering from this health condition.

Medicare Coverage for Chronic Obstructive Pulmonary Disease Treatments (COPD)

Medicare covers a variety of treatments for beneficiaries that are diagnosed and living with COPD.

Covered Medicare Treatments Include:

  • Prescription Medications
  • Pulmonary Rehabilitation
  • Oxygen Therapy
  • Bronchodilators
  • Inhaled Steroids

Medicare covers people aged 65 and over or under 65 with certain medical conditions. There are four parts to Medicare. Different parts of Medicare provide coverage for COPD treatments.

Part A Coverage

Medicare Part A covers hospital and inpatient services. Most COPD treatments occur in an outpatient setting. When admitted to the hospital, Medicare Part A administers the required treatment.

Part B coverage

Coverage for doctor visits, outpatient medical services, laboratory testing, and durable medical equipment is provided by Medicare Part B. It pays 80% of the Medicare-approved amount after you meet your annual Part B deductible. This will leave you with the remaining 20% and any applicable excess charges.

COPD treatments covered under Medicare Part B include pulmonary rehabilitation and oxygen. The inhaled steroids and bronchodilators could be covered under Part B if used with a nebulizer.

Medicare Advantage Coverage

Medicare Part C is another way to take advantage of your Medicare benefits. This coverage is an all-in-one plan that combines your Medicare Part A and Part B benefits in an easy-to-use option.

In addition, these Medicare Advantage plans include drug coverage and extra benefits that Original Medicare doesn’t cover. These plans can help limit the amount a Medicare beneficiary is responsible for paying for the year.

In addition, these plans have fixed copays for most services. It makes it more predictable than using only the Original Medicare Program alone.

Medicare Part D Coverage

Medicare Part D covers drugs you pick up from the pharmacy. You can get prescription drug coverage from either a stand-alone Medicare Part D plan or a Medicare Advantage plan that includes drug coverage.

Any prescription drugs or inhalers filled at a retail pharmacy to treat COPD fall under Medicare Part D coverage. It’s essential to verify your prescriptions are on the plan’s formulary.

Medicare Supplement Coverage

Medicare Supplement insurance plans are often called Medigap. These plans are secondary coverage for Original Medicare that help pay all or part of your cost share for Medicare.

In most cases, you’ll have to qualify to enroll in a Medicare Supplement plan medically. If you aren’t in your Medigap Open Enrollment Period or have a guaranteed issue right, your COPD will cause a denial of coverage for almost every Medicare Supplement policy.

FAQs

Does Medicare Part B cover COPD inhalers?

No, inhalers are prescription medications covered by Medicare prescription drug coverage. You can get them through either a stand-alone Medicare Part D prescription drug plan or a Medicare Advantage plan that includes prescription coverage. You should choose the drug coverage after verifying that the formulary matches your prescriptions.

Does COPD fall under a disability?

COPD can be considered a disability. The Americans with Disabilities Act classifies a disability as an impairment that is substantially limiting.

What is the average Medicare Part B fee for COPD?

Once you meet your annual Part B deductible, you can expect to pay 20% of the service, procedure, or equipment cost if you only have Original Medicare. Consider a Medicare Supplement or Medicare Advantage plan to offset some of the expenses you could be responsible for.

How does Medicare cover COPD?

Most of your services and procedures related to COPD are covered under Medicare Part B. Prescriptions filled at the pharmacy will be covered by your Medicare Part D prescription drug coverage.

Does Medicare cover oxygen for COPD?

Yes! Medicare coverage for oxygen under Medicare Part B.

What COPD inhalers does Medicare cover?

Medicare will cover Metered-dose inhalers (MDIs) & Dry powder inhalers (DPIs). Some covered inhalers are ProAir, Accuneb, Proventil, and Ventolin. The inhalers covered under your plan could differ. Make sure you check your plan’s formulary before enrolling to ensure proper coverage for your needs.

How to Find Medicare Coverage for COPD

Medicare has several types of supplemental Medicare plan types, but which path is correct for you? Let our licensed insurance agents can assist you throughout the process.

We can verify your doctors and prescription drugs are adequately covered. Educate you on the different choices and even help make the enrollment process simple.

For assistance, simply fill out our online request form or give us a call. Our licensed experts specialize in all aspects of Medicare and can help you no matter the situation.

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by Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.