Does Medicare Cover COPD?

Medicare Bob
Medicare General Info
Find out how Medicare covers COPD, including pulmonary rehabilitation program, oxygen equipment, and medications.
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COPD — or chronic obstructive pulmonary disease — is the third-leading cause of death in the U.S. As a group of chronic diseases, COPD leads to life-altering issues like emphysema, chronic bronchitis and asthma. It can also significantly raise the risk of severe illness from COVID-19, but COPD is often preventable and treatable. 

For Medicare beneficiaries managing moderate to severe COPD, Medicare Part B covers a comprehensive pulmonary rehabilitation program to help patients breathe more easily and live a more independent life. 

The Part B deductible applies, and costs for this service can vary but could depend on a few factors, like:

  • Other insurance policies the patient may have

  • How much the individual doctor will charge

  • Whether the doctor accepts assignment

  • The type of facility in which the program is administered

  • The location of the test, item or service performed

Patients will need a referral for this program from the doctor currently treating their COPD.

The Centers for Medicare & Medicaid Services created this video to help those with COPD understand their Medicare coverage.

What COPD Equipment or Prescriptions Will Medicare Cover?

Depending on the severity of the condition, Medicare will cover various equipment, accessories and medications to help treat and manage COPD. 

Medicare Part B covers oxygen equipment and accessory rental, as well as a humidifier, for use in the patient’s home if they meet these four conditions:

  • A doctor diagnoses severe lung disease or agrees the patient isn’t getting adequate oxygen.

  • A doctor determines the patient’s health will improve with oxygen therapy.

  • The patient’s arterial blood gas level falls to a certain range.

  • Alternate measures have failed.

Medications that help open the airways — bronchodilators and inhaled steroids — are covered by Medicare Part D.

Click here to get a quote for a Medicare plan that covers COPD services and medication.

How Can I Prevent COPD Now?

Research by the American Lung Association shows that cigarette smoke causes nearly 90% of all COPD cases. Early detection of COPD is key for effective treatment, and Medicare Part B covers a lung cancer screening for beneficiaries who are:

  • Between the ages of 55 and 77

  • Either asymptomatic or is exhibiting no signs of lung cancer

  • Current smokers or have quit within the last 15 years

  • Previous smokers with a history of smoking an average of a pack a day for 20 years

  • Given a written order from their doctor

Patients must meet all these conditions and will pay nothing out of pocket if their doctor accepts assignment.

The decision to quit is the most important thing a smoker can do to reduce the risk of COPD and other serious pulmonary issues. Cancer.org data shows that just a few months after quitting, a non-smoker’s coughing and shortness of breath decreases, and just five to 10 years later, their risk of lung cancer is cut in half.

For current smokers interested in counseling to help them quit, Medicare Part B covers up to eight sessions in a 12-month period, free of charge to beneficiaries with a qualified healthcare provider who accepts assignment.

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LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.

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