Does Medicare Cover Treatment for Parkinson’s Disease?
Key Takeaways
- Parkinson’s disease affects the nerve cells in your brain in ways that can affect your movements and cause other symptoms.
- Managing Parkinson’s often calls for a team of healthcare providers and a variety of medications.
- Understanding your Medicare coverage will help you to access the care, services, and prescriptions you need to live this condition.
In his 2009 memoir, actor and activist Michael J. Fox wrote that living with Parkinson’s disease had taken away his physical strength, balance, and ability to live spontaneously. However, that didn’t mean he couldn’t have a fulfilling, meaningful, and productive life. He explained, “The only unavailable choice was whether or not to have Parkinson’s. Everything else was up to me.”
A 2022 study estimated that 90,000 people in the U.S. are diagnosed with Parkinson’s disease each year. Since the disorder’s onset usually happens after the age of 60, the number of Americans living with Parkinson’s will likely shoot up as the population’s average age increases.
There is no cure yet, but medical treatments are available to reduce symptoms, improve quality of life, and allow people to continue making choices about their own futures. Currently, about 90% of Parkinson’s patients get their health coverage through Medicare, the insurance program for people who are over 65 or who have certain disabilities. If you (or a loved one) have been diagnosed, you should know what to expect and understand how Medicare coverage can help.
Living With Parkinson’s Disease
Parkinson’s disease affects the nerve cells in your brain, including the ones that produce dopamine. This chemical is involved in controlling movement as well as the feelings of pleasure or satisfaction, concentration, sleep, and other functions.
Symptoms are different for every individual and tend to become more severe over time. Often, an issue will only affect one side of the body at first before spreading to the other. According to the National Institutes of Health, the most common symptoms are related to movement and include:
- Shaking, referred to as tremors, usually starting in one of your limbs
- Stiff muscles
- Loss of balance and coordination
- Moving slowly, which can make it difficult to perform simple tasks
Patients may experience additional symptoms like:
- Depression and other emotional changes
- Memory problems
- Stooped posture
- Slowed or slurred speech
- Difficulty chewing and swallowing
- Struggling to write
- Lack of energy
- Aches in muscles and joints
- Oily skin
- Urinary issues or constipation
- Loss of automatic movements like swinging your arms while walking
Parkinson’s Disease Treatment
People with Parkinson’s often see multiple healthcare providers, starting with a movement disorders specialist. This is a type of neurologist, a doctor who studies the brain and nerves, who mainly focuses on the unique issues involved in living with a health condition like Parkinson’s.
Depending on the individual’s symptoms and needs, they may also work with professionals like a physical therapist who provides exercises to manage difficulties with movement and balance. An occupational therapist can adjust your home or workplace, making it easier to complete daily tasks. A speech-language pathologist assists people who have problems with speaking, communicating, and swallowing.
People with Parkinson’s disease take various medications to manage their symptoms. Levodopa, the drug that doctors most commonly prescribe, reduces issues with slowed movement by helping your nerve cells create more dopamine. It’s usually taken along with carbidopa, which reduces side effects like nausea and vomiting. Along with any prescribed drugs, a healthy diet, regular exercise, and stretching can also make a difference in symptoms.
In certain cases, healthcare providers may recommend a surgery such as deep brain stimulation. This operation involves implanting electrodes in the brain and connecting them to a battery placed in the patient’s chest. By stimulating targeted areas of the brain, the device can reduce movement-related symptoms.
Ready for a new Medicare Advantage plan?
Medicare Coverage for People With Parkinson’s Disease
Original Medicare, the federally administered health insurance for older Americans, can cover much of the medical treatment to manage Parkinson’s disease. There are two parts to Original Medicare:
- Part A is hospital insurance, which helps with the costs of inpatient care like hospital stays and deep brain stimulation. This part of Medicare can cover limited, part-time home health care when medically necessary for people with mobility difficulties, but not long-term, around-the-clock care.
- Part B is medical insurance, which helps with the costs of outpatient care such as visits to a neurologist and other doctors, physical therapy, occupational therapy, speech therapy, lab tests, and mental health services. Part B also covers durable medical equipment like walkers, wheelchairs, and hospital beds. You’ll pay a monthly premium for Part B ($174.70 for most people in 2024) and need to meet an annual deductible ($240 in 2024) before the insurance starts to pay for your care. After that Medicare will generally pay 80% of the cost of covered care that’s considered medically necessary.
To get coverage for most medications, such as levodopa, people on Original Medicare need to enroll in a Medicare Part D plan from a private insurance carrier. Details vary by plan, so it’s important to check that all the drugs you need will be covered and learn how much you’ll pay in monthly premiums, an annual deductible, and copays for each prescription.
A Medicare Supplement plan, also called Medigap, assists with the costs that aren’t covered by Original Medicare. After you’ve turned 65 and enrolled in Medicare Part B, you have a six-month period when you can purchase a Medigap plan from a private insurance carrier without any chance of being denied coverage or charged more due to your medical condition.
If you prefer, you may choose to enroll in a Medicare Advantage plan, sometimes referred to as Medicare Part C, which substitutes for Original Medicare. These plans from private insurance carriers are required to match the coverage from Parts A and B, including for all treatments related to Parkinson’s disease, and they set an out-of-pocket maximum on your annual spending.
Most Medicare Advantage plans include Part D prescription drug coverage, and they may feature other supplemental benefits. For example, people with Parkinson’s disease may be interested in seeking a plan that provides a gym membership, in-home fitness classes, transportation assistance, or companion care at home.
Parkinson’s disease is a complex and difficult disorder to manage. No one should have to do it alone. If you or a loved one have been diagnosed, then finding the right health coverage is a vital step to maintain the best possible quality of life in the years ahead.
Sources
Parkinson’s Disease: Causes, Symptoms, and Treatments. NIH.
Care access and utilization among Medicare beneficiaries living with Parkinson’s disease. Nature.
Dopamine: The pathway to pleasure. Harvard.
Building Your Care Team. Parkinson’s Foundation.