Medicare Guidelines for Hospice Parkinson’s Disease


Medicare Guidelines for Hospice Parkinson’s Disease

Parkinson’s disease is a neurodegenerative, progressive disorder. It is the second most prevalent form of neurodegeneration after Alzheimer’s disease. The cause of Parkinson’s disease is not fully understood, and there is currently no cure. Parkinson’s disease treatments focus on symptom management and control. There are numerous subtypes of Parkinson’s disease, as well as related neurological conditions known as “parkinsonism.” These various kinds include original Parkinsonism, atypical parkinsonism (secondary parkinsonism), parkinsonism caused by drugs, and parkinsonism vascular (cerebrovascular disease).

Medicare covers Parkinson’s disease treatments that are medically necessary, including medications, various forms of therapy, and hospital stays. Based on the type of coverage you have, you may have some out-of-pocket expenses, such as copays, coinsurance, and premiums. Medicare may not cover all of the services you require, including assistance with activities of daily living. If you or a loved one has Parkinson’s disease, it is important to comprehend which Medicare parts cover which treatments to avoid unexpectedly high costs.

Parkinson’s disease coverage under Medicare

Medicare consists of numerous components, and each section addresses the various services and treatments required to manage Parkinson’s. Part A and Part B comprise Original Medicare.

Part A Coverage

Part A covers a portion of your inpatient hospitalization expenses, including inpatient hospital care, operative procedures, and limited or intermittent specialized nursing facility care for hospice patients. Medicare Part A is free for the majority of beneficiaries, but you can expect to pay a deductible of $1,484 per benefit period in 2021 before your services are covered. If you remain in the hospital for over 60 days, you may incur additional coinsurance charges of $371 daily. After 90 days, the price increases to $742 per day for each lifetime reserve day used until the reserve days are depleted. After that, you are financially responsible for the total cost of hospital care.

Part B Coverage

Part B covers medical ambulatory expenditures, such as diagnosis, treatment, and prevention. The following items and services related to your care are covered by Part B:

  • Outpatient services such as primary care physician and specialist consultations
  • Diagnostic tests and preventive services
  • Diagnostic procedures
  • DME (durable medical equipment)
  • Rescue services
  • Physiotherapy and occupational therapy
  • Speech pathology
  • Psychiatric care

In 2021, the monthly standard premium for Medicare Part B is $148.50, and there is a Medicare Part B annual deductible of $203 in 2021. After meeting your deductible, you will only be responsible for 20% of covered services provided under Medicare Part B.

Part C Coverage

Medicare Part C (Medicare Advantage) is a private insurer-offered health insurance plan that varies by project but must provide the same protection as original Medicare. Some Part C plans also include coverage for prescription drugs and additional services like vision and dental care. Typically, Part C plans require you to choose your physicians and providers from within their network. Variable out-of-pocket costs for Medicare Part C programs range from monthly premiums to copayments, coinsurance, and deductibles. In 2021, the highest conceivable Part C deductible is $7,550. Some Part C plans require you to pay 20 percent coinsurance until you reach a plan-specific out-of-pocket maximum. Always verify your coverage to determine the expected out-of-pocket expenses.

Part D Coverage

Part D, which covers prescription drugs, is also purchased from a private insurance provider. The list of medications covered by various plans is known as a formulary. While all Part D plans cover some of the medicines you may need to treat Parkinson’s, it is crucial to verify that any medication you are currently taking or may need in the future is covered by your plan. Similar to Medicare Part C, Medicare Part D plans differ in premiums, deductibles, and copayments. Each Part plan also includes a formulary that details the tier-based costs for specific medications.

Medigap Coverage

Medicare supplement insurance, or Medigap, fills in some or all of the financial voids left by original Medicare. These expenditures may include deductibles, coinsurance, and copayments. You cannot purchase a Medigap policy if you have a Part C plan. There are numerous Medigap plans from which to choose. Some provide broader coverage than others, but their premiums are more expensive. Medigap does not cover the cost of prescription medications. Medigap plans vary in both cost and coverage, and some plans offer higher deductibles and reduced monthly premiums.

Parkinson’s Treatments Covered

Parkinson’s disease can be accompanied by a variety of motor and nonmotor symptoms, and the symptoms of this condition can vary from person to person. Due to the progressive nature of the disease, the symptoms may alter over time. Medicare covers a variety of treatments, medications, and services that you may require throughout your life to manage Parkinson’s disease. Parkinson’s disease treatments covered include medications that can mimic or substitute dopamine and other drugs known as COMT inhibitors. Medicare also covers therapies and services such as ultrasound-focused treatment, cognitive stimulation, pump Duopa, expert nursing care, physical and occupational therapy, speech therapy, counseling in mental health, and durable medical equipment (DME).

Medicare does not cover all medically necessary services, including non-medical custodial care for daily living activities like clothing, bathing, and cooking. Medicare does not cover long-term care or care around the clock. Devices that could make life simpler at home, such as a walk-in Jacuzzi and stair lift, are also not always covered. Parkinson’s disease is characterized by a progressive decline in cognitive and motor abilities, and Medicare covers a vast array of remedies and medications that can be used to alleviate the symptoms of this condition and enhance your quality of life. If you have queries, concerns, or require assistance regarding Medicare’s hospice care guidelines for Parkinson’s disease patients, please contact us at 1-888-635-6347. Our devoted team of specialists is here to assist you at every stage. Thank you for selecting us as your trusted source for Medicare hospice care guidelines for Parkinson’s disease patients, and we look forward to assisting and supporting you on this voyage.

Melodia care hospice CTA Button