COPD: the Causes, Symptoms, and What Medicare Covers

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As you get older, symptoms of serious illnesses may be missed, or simply mistaken as signs of aging. This is often the case with COPD (chronic obstructive pulmonary disease). COPD is the third-leading cause of death in the United States, and many people may have the disease without even knowing it.

COPD is a chronic inflammatory lung disease that causes the obstruction of airflow from the lungs. While it isn't curable, COPD is treatable, and your Medicare plan may help cover the costs of treatments.

There are two conditions that most commonly contribute to COPD — emphysema and chronic bronchitis.

"Emphysema is where the walls of the lung sacs become damaged, so there's less oxygen that's able to come in through those lung walls. Chronic bronchitis is where the lining of the lungs thickens with mucus, which makes it harder to breathe," explains Betsy Farrell, RN, BS, MHA, and director of performance management at Aetna. "So with COPD, you're not only struggling to get oxygen into your lungs, but your lungs are also struggling to take that oxygen and get it out of your body."

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Don't miss the warning signs of COPD

Spotting early warning signs of COPD can be tricky, as symptoms don't often appear until lung damage has occurred.

"You won't all of a sudden go into a respiratory fit and then get diagnosed with COPD. You'll likely notice something has been going on beforehand," she says. Here are some key symptoms to watch for, according to the Mayo Foundation for Medical Education and Research:

  • A chronic cough that may produce mucus (sputum) that may be clear, white, yellow, or greenish
  • Mucus production at least three months a year for two consecutive years
  • Shortness of breath, especially during physical activities
  • Wheezing
  • Chest tightness
  • Having to clear your throat first thing in the morning, due to excess mucus in your lungs
  • Frequent respiratory infections
  • Lack of energy

These symptoms can worsen and cause more serious symptoms that should prompt you to seek medical care right away.

"If you notice the nail beds of your fingernails or toes are blue or gray, you should seek medical care. This could indicate you're not getting enough oxygen circulating through your body," says Farrell.

Lack of oxygen to the brain can cause mental fogginess, which Farrell says is another medical emergency. So if you feel like you can't stay focused or function normally, or have trouble forming sentences and remembering things, get medical care immediately.

Farrell also warns of severe shortness of breath. "If you're struggling so much to breathe that you're having trouble talking, that's also a state of emergency," she says.

Your lungs are greatly compromised when you have COPD, so get the flu shot (if your doctor recommends it) each year and remember to wash your hands frequently to get rid of germs.

What's covered under Medicare

COPD can be treated through smoking cessation therapy, medications, oxygen therapy, and pulmonary rehabilitation. Medicare helps cover many of these treatments.

"Medicare Part B covers smoking cessation at no extra cost, and Medicare Advantage plans may offer additional programs to support smoking cessation," says Farrell. Oxygen therapy and pulmonary rehabilitation may also be covered under Medicare Part B if your doctor says they're medically necessary.

Medications, such as a bronchodilator, may be covered under your Medicare Advantage plan if you have prescription drug coverage.

"A bronchodilator is an inhaled medication to help open the airways, and often prescribed for people with COPD. But as with any medication, your coverage is going to be dependent on what type of Medicare prescription drug plan you have," says Farrell.

The coverage, costs, rules, and restrictions for COPD treatment will vary based on your plan. So it's important to call your plan for specific details about your COPD treatment coverage before receiving treatment.

If you feel you're experiencing the symptoms of COPD, call your doctor to set up an appointment. Catching it early is key to getting the treatment you need to maintain your health and well-being.

Rachel Quetti is a health care writer at Aetna with experience in senior wellness, Medicare, commercial health care, and consumer engagement. When Rachel isn't trying out new fitness classes, she is cooking up fun, (mostly) healthy recipes in the kitchen. Rachel lives in Watertown, Massachusetts and has a degree in journalism from the University of Massachusetts, Amherst.

Speak to a licensed Aetna representative about Medicare
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1-833-217-8226 (TTY: 711)

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