Does Medicare Cover COPD Treatments?

Medicare covers some COPD treatments but not others. Read on to learn what COPD is, some of the most common treatments and what Medicare covers.

What is COPD?

Chronic obstructive pulmonary disease, or COPD, is a progressive disease that can cause coughing, chest tightness, mucus, wheezing and shortness of breath, according to the National Heart, Lung, and Blood Institute. It is also known as chronic bronchitis or emphysema.

It is a relatively common disease that impacts about 1 in 9 Medicare beneficiaries.

Cigarette smoke or long-term exposure to lung irritants like chemicals, air pollution and dust may cause COPD.

The disease becomes worse as it progresses and can limit your ability to perform daily activities.

What Treatments Does Medicare Cover?

There are two common COPD treatments: supplemental oxygen and prescription drugs.

COPD Inhalers Covered by Medicare

• Supplemental oxygen can help COPD sufferers get more oxygen into their bloodstream and help get rid of excess carbon dioxide.
• Medicare has specific rules about covering this treatment, according to the COPD Foundation. If you need supplemental oxygen treatment, you will have a five-year contract with Medicare and your home oxygen supplier.
• During this contract, Medicare Part B will pay for 80 percent of the approved charges from the oxygen supply company. You are responsible for paying for the remaining 20 percent of the costs.
• A comprehensive Medicare Supplement Insurance plan, such as Plan F, would fully cover these additional 20% charges and your Part B deductible, meaning you could potentially pay nothing out of pocket.

COPD Meds Covered by Medicare

• There are several prescription drugs that can help COPD patients. The prescriptions come in many different forms including pill, capsules, mist or powder. One type is a “controller” medication that has to be taken daily to keep your lungs open. Another type is a “rescue” medication, such as inhalers, which help open your lungs quickly and are used in emergency situations.
• Medicare Part A and Part B do not cover prescription drugs in most cases. You would need to enroll in a Medicare Advantage plan with prescription drug coverage or enroll in a Medicare Part D prescription drug plan.
• The exact formulary (what drugs are covered and how much you may pay) will vary for each individual plan.

Learn More

For more information about Medicare coverage for other illnesses that impact Medicare beneficiaries, feel free to read our other articles below.

• • Does Medicare Cover Walkers?
  • Does Medicare Cover Chemotherapy?
  • Does Medicare Cover CPAP Machines?