Does Medicare Cover Parkinson’s?
If you’re concerned about Parkinson’s disease, you’ve probably done some research on the estimated cost of care — and you might be more than a little alarmed. The good news: Medicare may help ease the financial burden by lowering your treatment costs and improving your quality of life.
A broad range of services, including occupational, physical and speech therapy, as well as medications and hospital stays, are typically considered medically necessary for this condition and can be covered by Medicare.
Let’s take a closer look at Parkinson’s disease and how Medicare may be able to help with treatment.
Understanding Parkinson’s Disease
Parkinson’s is a neurodegenerative disorder that primarily affects movement but can also affect cognition (i.e., the way you think). Nearly 1 million Americans are living with Parkinson’s disease, a figure expected to climb to 1.2 million by 2030. If you’re at risk of developing Parkinson’s, keep an eye out for its four main symptoms:
Tremor (trembling) in hands, arms, legs, jaw or head
Stiffness of the limbs and trunk
Slowness of movement
Impaired balance and coordination
Because Parkinson’s is a chronic condition with no cure, treatment focuses on managing or reducing symptoms. Your doctor might prescribe medications, therapy, surgery or a combination of these approaches.
Living with Parkinson’s comes with a hefty price tag: The Parkinson's Foundation estimates that the combined direct and indirect cost (including treatment, Social Security payments and lost income) is almost $52 billion annually for the U.S. alone. Parkinson’s medications average about $2,500 per patient each year, and therapeutic surgery can cost up to $100,000. Given all this, it’s important to know what your Medicare benefits may cover for Parkinson’s disease.
What Does Medicare Part A Cover?
Medicare Part A, designed to provide coverage for inpatient hospital stays, can be beneficial for those living with more advanced cases of Parkinson’s. This form of Medicare coverage may also cover up to 100 days in a skilled nursing facility, which could be useful if you are recovering from a Parkinson’s-related fall, for example, and are well enough to leave the hospital but still require medical supervision as you recover.
Surgery would also be considered under Medicare Part A.
What Does Medicare Part B Cover?
Any outpatient treatments, such as doctor’s visits, lab work and single-day procedures, would fall under Medicare Part B. For Parkinson’s patients, this could include:
Physical therapy, which you might need to help regain strength after a fall. You might also receive physical therapy to maintain mobility, strength and balance.
CT scans, which may show brain atrophy or help your doctor observe other brain changes due to Parkinson’s disease
Medication infusions or injections may be used if oral therapies (i.e., pills) do not provide adequate relief for Parkinson’s symptoms. Sometimes, oral medications work at first and then stop working, in which case infusions or injections of medications may be considered.
Therapy for incidents related to Parkinson’s diagnosis, such as recovery from a fall, stroke or surgical procedure
Medical equipment needed to manage symptoms
Medicare Part B might also cover parts of Duopa therapy, an innovative procedure used to treat motor symptoms in advanced Parkinson’s. In this procedure, medication is delivered through a tube directly into the patient’s intestine. Medicare Part B may cover the cassettes used for the Duopa pump or imaging needed for the Duopa procedure.
What Does Medicare Part D Cover?
Medicare Part D may cover medications used for Parkinson’s treatment, such as carbidopa and levodopa, which help alleviate tremors, stiffness and movement difficulties. These medications work together to raise your body’s levels of dopamine, a neurotransmitter that sends signals to the area of the brain responsible for movement. (Parkinson’s symptoms result from low dopamine levels.)
Medicare Part D might also cover drugs used during “off” periods for Parkinson’s — those times between regular treatment doses when tremors and other symptoms may return.
Medication is an important part of keeping Parkinson's symptoms at bay, and a Part D plan can help cover those costs.
What Else Can Help With Parkinson’s Costs?
A Medicare Supplement — or Medigap — plan (such as Plan G), may pay 100% of your Part A coinsurance and hospital costs, as well as 100% of Part B coinsurance and copayments. All Medigap plans are different, with some paying deductibles and other excess charges. Talk with your healthcare provider to determine your needs.
To learn more about the right coverage for you, call 1-833-463-3262, TTY 711 to speak with a licensed agent at Senior Healthcare Direct.
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.