ORIGINAL MEDICARE
The federally funded health insurance program provides coverage for Americans both under and over the age of 65 living with an epilepsy diagnosis. Evaluating this condition must be done carefully by the patient and the healthcare provider. This condition is complex and specific to the individual.
Medicare Coverage for Epilepsy is a concern for many Americans. Over 570,000 adults over the age of 65 are living with epilepsy in the United States as of today. As the baby boomer generation nears retirement age, that number is on the rise. Epilepsy doesn’t discriminate, favoring no rage, age, social class, national or geographical limitations.
Below, we’ll answer some common questions we receive from our clients regarding what Medicare will cover when diagnosed with Epilepsy.
Does Medicare Cover Deep Brain Stimulation for Epilepsy?
Does Medicare Part D Cover Drugs for Epilepsy?
The most popular form of treatment for controlling and limiting seizures is with epilepsy medications. Although, epilepsy treatment needs may vary from one person to another; no one medication works for all individuals. Coverage includes the six classes under Medicare Part D. The policy of classes ensures a higher level of protection for six different classes of medications.
Classes include anticonvulsants for epilepsy. Although there’s no substitution for the medication’s providers’ use in treating epilepsy, patients respond in a different way to available treatments.
Individuals living with epilepsy want full access to all the therapy options available (including the specialists who can prescribe them). Many beneficiaries suffering from epilepsy aren’t fond of switching medications or altering their treatment plans.
The reason being these changes can induce breakthrough seizures. The problem – breakthrough seizures may increase complications and/or the costs of service. In severe cases, this can cause death.
Fortunately, in May 2019 the Centers for Medicare & Medicaid Services gave the existing Medicare Six Protected Classes policy validation. The Part D rule was finalized, giving more importance to the policy for individuals with complex acute as well as chronic health conditions. Epilepsy was among these conditions.
Due to the loud voices of the Epilepsy Foundation, CMS has a new rule for patients with severe and complex health care needs. Including, mental illness, epilepsy, HIV, cancer, and organ transplants.
Patients with such conditions must have the opportunity to seek the entire range of medications available to treat or manage their condition and maintain a decent quality of life.
Does Medicare Special Needs Program Cover Epilepsy?
Does Medigap Cover Epilepsy?
How to Get Extra Medicare Coverage for Epilepsy
Our team of licensed Medicare agents is up-to-date on the latest Medicare information. Suffering from a disability or condition is always challenging, your health insurance coverage doesn’t need to be. Let us do the hard work for you and help you find the best plan for your budget and health needs.
If you still have questions or concerns about coverage and epilepsy, contact your local agent today. Here at MedicareFAQ, all we know is Medicare. We can provide quotes, compare plan options, and answer any questions you may have.
Our team provides you with the information you need to choose the right healthcare plan for your needs. Give us a call today at the number above. If you can’t call, fill out our online rate comparison forms.
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