Medicare's Coverage of Parkinson's Disease

Parkinson’s disease is a neurodegenerative disorder that can steal your quality of life is it progresses. Unfortunately, there is no cure for the disease currently. There are treatments available to slow the progression of symptoms. This is the best way to preserve your quality of life. But, this can also get expensive. If you’re enrolled in Medicare, your coverage may be able to reduce some of these out-of-pocket costs for you.

Durable Medicare Equipment Coverage

On a day-to-day basis, anyone living with Parkinson’s disease may rely on the aid of assistive technology and devices. For Parkinson’s disease, you’ll likely encounter these for safety or convenience reasons. For example, mobility aids like canes or walkers help you get around your home and neighborhood with ease and safety. They may also refer to certain home safety aids like smart home technology and medical alert systems. Some devices may also aid in fall prevention. Others help ease some day-to-day tasks like dressing, eating, and communicating.

Medicare does cover certain durable medical equipment (DME) under Medicare Part B. In order to qualify for coverage, it must be: ordered by a doctor, must be useful for a medical reason, wouldn’t be useful for a healthy person, usable at home, and be usable multiple times with a lifetime of up to three years. This would make some of the eating, dressing, and smart home technology not coverable. Many of the mobility aids, fall prevention devices, or communication aids, and some others, may be covered. Check with your doctor to see if a piece of DME would qualify for coverage. If it’s covered, you’ll pay 20 percent of the Medicare-approved cost after meeting your Part B deductible or a cost defined by your Medicare Advantage plan if you have that instead.

Medicare Coverage for Drug Treatment

One of the most common treatments for symptoms of Parkinson’s disease are prescription medications. Working with your doctor, you’ll come up with a drug regimen to reduce your symptoms while accounting for any other medications you may be taking. These medications often either replace or mimic the effects of dopamine in your brain. Some examples of common Parkinson’s disease medications are levodopa, adenosine receptor antagonists, COMT inhibitors, dopamine antagonists, and MAO B inhibitors. Under Medicare, your drug costs may be covered under Medicare Part D or Medicare Advantage if your plan has drug coverage. To know what’s covered and how much you’ll owe, you’ll need to see your plan’s formulary. If your medications are being given as part of inpatient care, they may be covered under Medicare Part A.

Inpatient Care Coverage for Parkinson’s Disease

There may be times when impatient care is needed to help you treat Parkinson’s disease. At some point, you may also decide that you need the aid of skilled nursing facility or home health care. If you run into these situations, your medical care should be covered by Medicare Part A as inpatient care. After meeting your Part A deductible, you’ll be covered for medical care for your first 60 days. For days 61 to 90, you’ll owe a daily coinsurance. After that, you’ll dip into your lifetime reserve days. Skilled nursing facilities have a different coinsurance for that care. This coverage is only for medical care. Any day-to-day care, like using the bathroom or bathing, is considered maintenance care and is covered by long-term care insurance, not Medicare.

Medicare Coverage for Therapeutic Treatment

Another way that some doctors look to help with Parkinson’s disease symptoms is through different therapies. There are a lot of options out there for Parkinson’s disease patients, so instead of listing them all, we’ll focus on the ones that are covered by Medicare. Deep brain stimulation is an FDA-approved treatment for tremors and movement disorders that has been covered by Medicare since 2003. It may be inpatient or outpatient care, meaning it may be covered by Part A (inpatient) or Part B (outpatient). Some states also have access to coverage for focused ultrasound therapy, a noninvasive treatment for early-stage Parkinson’s disease.

There are other forms of therapy that are both covered by Medicare and sometimes useful for treating symptoms. Physical therapy focuses on larger muscle groups and can help maintain basic day-to-day mobility. Occupational therapy deals more with performing tasks. Since Parkinson’s disease affect speech, your doctor may also order speech therapy, which may help you communicate as the disorder progresses. If they’re considered medically necessary by your doctor, physical therapy, occupational therapy, and speech therapy should all be covered under Medicare Part B. Finally, it’s not uncommon for people living with Parkinson’s disease to experience depression, anxiety, or other emotional disorders. Luckily, Medicare covers mental health and counseling services under Medicare Part B.

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A Parkinson’s disease diagnosis is a lifechanging and is a scary one. Since there is currently no known cure to the disorder, that leaves treating the symptoms as your option for slowing the progression of the illness and maintain your quality of life. Since this is a lifetime of treatment, having the backing of Medicare can help you afford your Parkinson’s disease treatment plan while still affording to live your life on your own terms.