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asthma inhalers fall under Medicare Part B or D coverage

Medicare Coverage for Asthma Inhalers

Asthma is a common disease found in older adults. It can cause severe health problems when it’s not treated correctly. If you’re an older adult or the caregiver for an older person, we hope this post helps you better understand asthma and how Medicare coverage applies.  

This information is not meant to displace medical advice from your doctor.

What Is Asthma and How Do You Manage It?

It’s a chronic disease in which someone’s airways become inflamed, narrow, and swelling, making it hard to breathe. Asthma may cause chest pain, cough, wheezing, or shortness of breath. It can be a minor condition or it can interrupt daily activities.  

The good news is that asthma can typically be managed with inhalers. “Rescue” inhalers are used to treat symptoms, and “controller” inhalers prevent symptoms. Severe cases may call for longer-acting inhalers or oral steroids. Also, older adults with asthma would benefit from regular vaccinations for influenza and pneumonia.  

What Is a Nebulizer?

A nebulizer is a medical equipment that someone with asthma can use to inhale medication quickly to the lungs. Specifically, it turns liquid medicine into a mist that a person may inhale through a mouthpiece or face mask. Nebulizers come in electric or battery-run editions, and the devices are covered under Medicare Part B, so long as they’re a “medical necessity.”  

Asthma: Quick Facts

  1. The majority of people with asthma first notice symptoms at an early age. However, people of any age can develop the disease. It’s not unusual for adults in their 70s or 80s to contract symptoms — for the first time.
  1. An asthma flare-up is most often caused by a respiratory infection or virus, allergens, exercise, or air pollution.  
  1. According to the U.S. Department of Health and Human Services Administration on Aging, over two million Americans — age 65 and older — have asthma. 
  1. Asthma is tough to diagnose in older adults because other health conditions have similar symptoms. Your doctor might interpret the coughing as a result of chronic bronchitis or congestive heart failure. When asthma symptoms aren’t identified correctly, they might remain untreated, likely creating severe health risks. 
  1. Older adults are more prone to develop respiratory failure due to asthma.

Special Considerations in Treating Asthma

Treating asthma in older adults can be complicated. Many older folks take several medications for different health conditions. Some asthma medications react with other treatments, causing harmful side effects. Additionally, other drugs can make asthma symptoms worse.  

Note: If you experience asthma symptoms during your regular activities like shopping, gardening, or walking, talk with your physician ASAP. 

Related Post: Medicare and Gastroparesis Medication 

What Will Medicare Cover for Asthma?

If your doctor prescribes an asthma inhaler, Medicare will pay for it. Your doctor should provide a prescription and fill out a form stating that you need a nebulizer. Doctors and suppliers must accept Medicare assignment, and the doctors need to list the inhaler as “Durable Medical Equipment” for Part B to cover it. 

Further, Part D can help lower inhaler prices. But, coverage kicks in after your physician writes a script.

Types of Inhalers

There are different types of asthma inhalers and inhalation solutions. These will fall under Medicare Part B or Part D coverage, depending on whether you use the drug with a nebulizer or through an inhaler.  

  • Albuterol
  • COPD inhalers
  • Bronchodilators
  • Symbicort

Related Post: Durable Medical Equipment Coverage

What Else You Should Know

Medicare Parts A and B pay for asthma treatment apart from medications. If you have an asthma attack and you’re in the hospital, Part A coverage takes up hospital charges. 

Get Help Paying for Asthma Inhalers

When you don’t have supplemental insurance, Medicare Part B and D costs can add up quickly. Medigap policies have numerous benefits — you don’t have to worry about some deductibles and coinsurances. Plus, you can visit any doctor that accepts Medicare, and you don’t need a referral to see specialists. An agent at TSS can walk you through your plan options and help you find the best policy. Call (855) 952-1941 to get started!