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Options For Parkinsons Disease Care
These burdens can ultimately lead a family caregiver to explore alternatives for Parkinsons disease care. Eventually, many decide to place their loved ones in long-term care facilities, such as assisted living or a nursing home.
Assisted living residents usually receive help with daily tasks, meal preparation, medication management, and escorts to doctors appointments. A nurse is onsite 24/7 and apartments are equipped with emergency call buttons so residents can summon help when necessary.
However, assisted living facilities generally arent equipped to care for people with severe mobility problems or advanced dementia. As a result, your loved one will likely be transferred to a skilled nursing facility once they reach the advanced stages of Parkinsons disease. Unfortunately, the expense of assisted living could quickly deplete their financial resources, limiting your choice of facilities to Medicaid nursing homes.
Nursing homes have their own issues. Even the best facilities tend to be understaffed, and few can provide the level of one-on-one care most people desire for their loved ones. Residents will be competing with each other for staff members limited attention, and those with advanced Parkinsons disease may not be able to communicate in a way that ensures their needs are met. These same issues may also make Parkinsons disease patients more vulnerable to physical or sexual abuse.
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What Inpatient Physical Therapy Does Medicare Cover
Medicare Part A covers inpatient stays in hospitals, skilled nursing facilities and some home care, as well as physical therapy at inpatient rehabilitation facilities. It may also cover in-home services if youre eligible for home care or services you receive at a skilled nursing facility after a three-day hospitalization.
Your out-of-pocket costs, such as deductibles and coinsurance, depend on the treatment setting. For example, your share of the cost is different if you receive inpatient care in a hospital vs. a skilled nursing facility.
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Causes Of Parkinsons Disease
Parkinsons disease is an idiopathic illness, which means that its cause is unknown.
The signs and symptoms it present are caused by the loss of nerve cells in the part of the brain called substantia nigra.
This part of the brain is responsible for the production of dopamine, a neurotransmitter that links the brain and nervous system to coordinate body movements.
Loss of dopamine results in uncoordinated body movements, thereby producing the signs and symptoms of the disease.
Though the exact cause of Parkinsons disease is still unknown, there are possible explanations that may be responsible for the condition, such as:
- Genetics. Studies have shown that a minority of cases of PD have genetic involvement.
- Environmental factors. Exposure to pesticides, herbicides, and industrial pollution is now being looked at as a possible cause of PD. However, the results are still inconclusive.
- Presence of Lewy bodies. Lewy bodies are clumps of substances in the brain cells. These are often seen in people with Parkinsons disease. The studies about them are still inconclusive, but researchers believe that these substances hold useful information to what causes PD. Researchers are also focusing into alpha-synuclein found in the Lewy bodies.
The following are the associated risk factors in developing Parkinsons disease:
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How Is Parkinsons Disease Dementia Diagnosed
No single test can diagnose Parkinsons disease dementia. Instead, doctors rely on a series or combination of tests and indicators.
Your neurologist will likely diagnose you with Parkinsons and then track your progression. They may monitor you for signs of dementia. As you get older, your risk for Parkinsons dementia increases.
Your doctor is more likely to conduct regular testing to monitor your cognitive functions, memory recall, and mental health.
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Does Medicare Cover Parkinsons Disease
Medicare covers specific medications, surgery, and ultrasound treatments that doctors commonly use to treat these with the disease of Parkinsons.
Original Insurance -disease , Part A covers surgical procedures in a hospital setting, while Part B covers outpatient procedures, laboratory tests and doctor visits.
A person with original health insurance can purchase a Part D plan for preion drug coverage, which would include medication for the condition.
The alternative to original health insurance is Medicare Advantage, which all provides Part A and Part B benefits under one policy. Most also include preion drug coverage.
This hasrticle examines Parkinsons disease coverage from each part of Medicare. He then describes the disorder, and discusses treatment options and supportive resources.
According to the Davis Phinney Foundation for Parkinson s, Medicare covers drugs and surgical treatment for the disease.
Additionally, as of , Medicare covers a procedure called targeted unilateral Thalamotomy ultrasound , which could help people with tremor-dominant Parkinsons disease.
Below, we take a look at the coverage details for each part of Medicare.
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What Does Medicare Part D Cover
Medicare Part D may cover medications used for Parkinsons treatment, such as carbidopa and levodopa, which help alleviate tremors, stiffness and movement difficulties. These medications work together to raise your bodys levels of dopamine, a neurotransmitter that sends signals to the area of the brain responsible for movement.
Medicare Part D might also cover drugs used during off periods for Parkinsons 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.
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Which Type Of Care Is Not Covered By Medicare Part B
Long-term care is not covered by Medicare or most health insurance plans. Non-skilled personal care is provided in addition to skilled care in which people bathe, dress, eat, move around, and use the bathroom.
The Medicare program is a government-run health insurance program that covers people 65 and older and people with certain disabilities. The Centers for Medicare and Medicaid Services is in charge of administering the program. The majority of essential treatments at public hospitals are covered by Medicare. Almost all of the costs of dental, optical, and ambulance services are not covered by Medicare. The costs of private hospital treatment are not covered by private health insurance, but they are covered. In general, people covered by Medicare purchase private health insurance in order to cover additional medical expenses such as dental care, glasses, contact lenses, and hearing aids. It is important for people to have access to medical care, and having health insurance through their employers or spouses employers can be a good option for them.
Behaviors Seen In Parkinsons Disease Dementia
As dementia progresses, managing disorientation, confusion, agitation, and impulsivity can be a key component of care.
Some patients experience hallucinations or delusions as a complication of Parkinsons disease. These may be frightening and debilitating. Approximately 50 percent of those with the disease may experience them.
The best thing to do when giving care to someone experiencing hallucinations or delusions from Parkinsons disease dementia is to keep them calm and reduce their stress.
Take note of their symptoms and what they were doing before they exhibited signs of hallucinating and then let their doctor know.
This element of the disease can be particularly challenging for caregivers. Patients may become unable to care for themselves or be left alone.
Some ways to make caregiving easier include:
- sticking to a normal routine whenever possible
- being extra comforting after any medical procedures
- limiting distractions
- using curtains, nightlights, and clocks to help stick to a regular sleep schedule
- remembering that the behaviors are a factor of the disease and not the person
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Gaps In Coverage For Neurological Disorder Treatments
Depending on your neurological disorder, severe symptoms may require extra services not covered by Original Medicare. Several services that arent covered include extended nursing home stays, custodial care, help with daily living tasks and meal delivery.
Original Medicare also lacks prescription drug coverage. But there are options to fill coverage gaps, like a Medicaid plan for qualifying low-income individuals.
Medicaid plans can help with coverage gaps for things like personal care, transportation to medical services and medications. You can be dually eligible for both Medicare and Medicaid.
Does Medicare Part B Cover All Medical Expenses
No, Medicare Part B does not cover all medical expenses. Part B only covers certain medically-necessary services and supplies.
Part B costs $164.90 per month as of February 15th. It is dependent on your income, so this figure may change from year to year. If you do not receive Social Security or Railroad Retirement benefits, you will be charged for your Part B premium.
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Medicare And Physical Therapy: What Services Are Covered
Outpatient therapy services covered by Medicare include:
- Physical therapy .
Medicare outpatient therapy services include services provided at locations such as:
- Therapists’ or doctors’ offices.
- Comprehensive outpatient rehabilitation facilities.
- Skilled nursing facilities.
- The patient’s home, if they utilize health home agencies when they do not qualify for Medicare’s home health benefit.
Medicare Part B does not cover physical therapy expenses in all situations. For example, if you get therapy during a Medicare-covered skilled nursing facility stay or under the home health benefit, you won’t get additional coverage under Medicare.
To find out if Medicare covers your particular therapy, visit the Medicare Physical Therapy site and input the name of your treatment.
Medicare Cover Medical Equipment
Original Medicare does not cover most medical equipment. However, some Medicare Advantage Plans and some Medicare Prescription Drug Plans offer coverage for certain medical equipment. If you think you need medical equipment, check with your plan first to see if its covered and how much youll have to pay.
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Which Neurological Disorder Treatments Does Medicare Cover
Commonly covered treatments for neurological disorders include physical, occupational and speech therapy services. There are also covered treatments that are tailored for specific neurological disorders. Your coverage for specific treatments will vary by the type of neurological disorder you have.
For example, Medicare covers deep brain stimulation if you have Parkinsons disease. DBS, a surgical procedure targeting brain activity with implanted electrodes and batteries to stimulate motor function, is the most common procedure for Parkinsons patients. But, if you have dementia, DBS could worsen your condition and therefore is not covered by Medicare.
Medicare Advantage plans bundle everything included in Original Medicare plus, typically, additional drug coverage and services. There could be benefits to choosing a Medicare Advantage plan, such as possible lower out-of-pocket costs for your neurological treatments than offered by Original Medicare, if you have a neurological disorder.
Coverage is subject to any copays, deductibles and/or benefit period rules you must meet before coverage begins. Whether you receive your treatments in an inpatient or outpatient facility can change your out-of-pocket costs.
Develop A Financial Plan
Dealing with a chronic illness is unpredictable, there is no way to know how you will feel or what you will be able to do days, months, or years from now. But, for your own security and that of your family, you need to plan ahead, and assume that Parkinsons will lead to increasing disability. There are professional financial managers and medical lawyers that deal with financial planning for people with chronic illnesses. Ask your doctor for a referral, or speak with a national association or support group to find a reputable professional in this area.
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Medicare Coverage And Parkinsons
Danielle Kunkle Roberts, Forbes Finance Council member and co-owner of Boomer Benefits
No one plans to spend their retirement battling a chronic illness, yet people on Medicare are diagnosed with such illnesses all the time. Dealing with a progressive chronic condition like Parkinsons can be particularly devastating and also expensive.
Parkinsons affects more than one million people in the United States, and these individuals can expect to spend more than $2,500 on medications each year. Costs for surgery can surpass six figures.
Its no surprise then that older Americans with Parkinsons have substantially higher health care spending than individuals without it. Fortunately, though, as these people with Parkinsons age into Medicare, they can set up their coverage to help cover many of the costs of treatment and medications.
When Does Medicare Cover Physical Therapy
When a service is required to diagnose or treat an ailment or illness, it is deemed medically necessary. Therapy may be necessary to:
- Make an improvement
- Maintain your current health state
- Keep your health as good as possible
The healthcare practitioner must be a trained physical therapist or doctor to cover the therapy. Medicare does not cover providing basic exercises for overall fitness.
Before providing you with services that are not covered, a formal notice from your physical therapist is required. After that, you can decide whether or not to use the services.
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Consider Your Medical Coverage Options
Employee Insurance. If you are insured, either through your employer or a retirement policy, read all of the policies pertaining to chronic illness. If you are unsure about the language or terminology, contact the personnel department or your financial planner.
It is important that your insurance agree to provide for a referral to a specialist in Parkinsons disease in the event that you should need one now or in the future. Not every neurologist is a specialist in Parkinsons disease. To be a specialist, neurologists undergo further training in movement disorders.
Private Insurance. If you are unemployed and you do not have coverage, you should look for the highest level of coverage that you can afford.
Medicare. If you are 65 or over, you will qualify for Medicare. You can supplement this insurance with a Medigap policy available through a private insurer. Note also that many states have prescription assistance/reimbursement programs for low-income senior citizens.
If you are disabled but too young to qualify for Social Security, you may be eligible to receive a form of Medicare for the disabled.
Medicaid. If you cannot get insurance and your income is low, you may qualify for Medicaid, a government safety net program that pays for medical costs that exceed a persons ability to pay.
What Is Parkinsons Disease
Parkinsons disease is a progressive, neurodegenerative disorder. It is the second most common neurodegenerative disorder after Alzheimers disease.
The cause of Parkinsons is not completely understood. Currently, there is no cure. Treatments for Parkinsons disease are based on symptom control and management.
There are several different types of Parkinsons disease, as well as similar neurological disorders known as parkinsonisms. These different types include:
- primary parkinsonism
- vascular parkinsonism
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Planning For Your Medicare Cost
We often meet new Medicare beneficiaries who are surprised to learn that Medicare is not free. In fact, it functions very similar to other employer group health insurance you may have had during your working years. These plans all have cost-sharing that you pay in the form of deductibles, co-pays and coinsurance. Medicare has the same.
Lets break down some of the cost-sharing items you will incur on each Part of Medicare. This will help you estimate your personal expected expenditures under Medicare.
When you have an inpatient hospital stay, a Medicare Part A benefit period is triggered. The Part A deductible per benefit period is $1,364 this year. A deductible is an amount that you pay out of pocket before your Medicare benefits kick in.
After you have paid your deductible, Medicare Part A covers all the rest of your inpatient hospital expenses for the next two months or 60 days. You wont incur any further co-pays unless you have a hospital stay that is longer than 60 consecutive days, and that is rare.
Its important to mention that its possible to have more than one benefit period in a calendar year. This occurs when you leave the hospital and are out of the hospital for 60 straight days, which closes the benefit period. If you go back into the hospital again, a new benefit period will begin, and you will owe the Medicare Part A deductible again.
What Is The Medicare Part B Premium For 2022
In November 2021, CMS announced that the Part B standard monthly premium increased from $148.50 in 2021 to $170.10 in 2022. This increase was driven in part by the statutory requirement to prepare for potential expenses, such as spending trends driven by COVID-19 and uncertain pricing and utilization of Aduhelm.
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How Much Will I Have To Pay If I Qualify
With Original Medicare coverage , eligible seniors will pay nothing for home health care services that are ordered by a doctor and provided by a certified home health agency. Any additional services provided outside of the approved care plan will not be covered and must be paid for out of pocket.
Be aware that before services begin, the home health agency should provide an itemized receipt or plan of care that identifies what is eligible for Medicare coverage and what is not. A written notice called the Advance Beneficiary Notice of Noncoverage will detail any services and durable medical equipment that Medicare will not pay for as well as the costs the patient will be responsible for.
Use the guide below to determine the combination of payment options that will help your family cover home care costs.