I'm new to this site. My 72 year old husband has been diagnosed with COPD for 12 years. As soon as he was diagnosed, he was given ventalon rescue inhalers along with other meds. We had no problem with employer provided insurance, however, my husband retired last June and went on Medicare. Today, we received a letter from our insurance provider stating Medicare doesn't cover ventalon unless in a hospital out patient setting. We will ask the pulminologist if there is an alternative to the rescue inhaler, however, I'm wondering if any other COPD Medicare eligible people have had this issue and how it was resolved.
I appreciate any answers.
Written by
LedaM
To view profiles and participate in discussions please or .
I prefer alternative approaches, myself. You might check out my thread on food grade hydrogen peroxide. I just learned there is someone who posted here about her success with taking it internally, 7 months ago. My last post in the thread is about that.
Hi LedaM: You are not the only one going through this, The two recommended inhalers for copd are Xopenex and Combivent Respimat. This year I can't get either one, because it isn't offered or they have upped the tier to where it is beyond my means to purchase. My dr. has recommended I use a nebulizer, the only problem with that is you can't take it with you in case you need it. Some one on the doctors staff is suppose to talking with insurance to see if they can get combivent respimat at a cheaper price. I'm waiting.
What does your insurance recommend your husband use? Usually they have another drug they are pushing.
They do make portable nebulizers that work with it's own re chargeable battery and can also plug into car or an outlet. Not sure of price but if your Dr.prescribes it then maybe it would be paid by insurance. Also, if you have continuous flow o2 such as the cylinders, you can get the extra tubing and neb. cups at most drug stores and I found if I set it on 4liters it works fine. Hope this helps hang in there we can make things work!
Thank you to all for the information on a portable nebulizer, I'm on Medicare and they purchased the home one so not sure if they will purchase a portable but will check on it. I will also research and see if I can find one I can afford to pay for by myself.
I had to purchase the portable one. Medicare paid for home one. Think i paid 100 .00 online. It is a respironic mini but you can use the same tubes etc as your home one.
You can contact the drug companies, they offer help for meds. look up manufacturer and go to their website there should be link for help if you can't afford them, I know combivent offers help. Contact your local Senior and disabled office they can usually help find you information and sometimes can help with contacting companies.
Hi ledaM. I am 70 years old and have a Medicare advantage plan and like your husband's Medicare plan, they keep restricting me from medicine that helps somewhat. I am on ProAir as an rescue inhaler. My plan covers some of it. I found using Anoro Elipta inhaler really helped my overall breathing but Medicare will no longer cover any of it. My pulmomologist then put me on Symbicort for 3 months followed by more pulmonary function tests. With results of tests we plan to appeal to Medicare proving that Anoro did a better job of keeping me breathing. Hopefully they will then cover at least some of the cost. Medicare has stopped covering so many of my prescriptions or pays very little of the cost. Unfortunately it's not about giving what is best for the patient but ensuring the insurance company makes the largest profits they can get. It is really frustrating. Ask your pulmomologist to help. Take care and may your husband and all suffers breathe well.
Cannabis Oil under our tongue is the answer google Cannabis Oil you are going to be surprised. Don't smoke it put under tongue . I'm researching all I can find on this. In state of Georgia COPD is not on legal medical side.Theres 8 illness (Cancer) #1 check your state
Kay15143 thank you for the information on cannabis oil. I also just started doing research on it myself. I've read recommendations from others to google Jeff Waters regarding the subject. I plan to watch his videos and will check the laws for PA. I'll let you know how I make out.
Kay15143...I just did some preliminary research on medical marijuana laws for the state of Pa. On 4/17/16 the governor signed the medical marijuana act into law making us the 24th state to male it legal. The law became legal May 16h but it will take another 18 to 24 months before the program is up and running. Also, to date COPD is not a qualified illness to be included in this law. Now I need to find out how I can obtain some oil to try for myself. Nothing ventured, nothing gained. I would like opinions on this subject. Has anyone else checked it out or tried the oil?
as guy i go to better breathers say it's helping him. I tried a bite of a muffin w/ butter and it felt like my breathing was stopped. Scaird me to death. so I would not recommed the eidbles. the other , well i have not worked up the nerve to try it. I used to smoke it for years
Thanks for your response and input valeriejean. When I was a young adult I tried marijuana but not for a medical condition. I thought Medicare advanrage eats the best but not so by far. It's great if you don't get sick or have a chronic disease. I would advise anyone starting on Medicare to tale the original Medicare and supplement "F" or something like that. Pays much better than the "advantage" supplement.
Because when I got on medicare I already had very severe copd or a cronic condition I was advised to get original medicare w/ a supplmental policy. The advantage plans seem superior but as you can see they can no be so good.
It certainly hasn't helped me. Is there any other rescue inhaler that has helped you and you could recommend? I ask because I have a pulmomologist appointment this week with PFT test again and need prescription refills. UGH!
Thanks everyone for all your replies on rescue inhalers. I will ask Dr. to try one of the ones that were mentioned here. My motto with this disease is "nothing ventured..nothing gained". Again, thanks for all the input. Take care and breath well!
Hi Leda, first of all, welcome to this site. After being here for about 2 months, I'm so pleased with the caring & encouragement from everyone. There's a wealth of knowledge & friendly advice here. I agree how frustrating it is dealing with insurance companies. I pray that this is resolved for you soon. God bless, Terri
I have a Ventolin HFA inhaler. It works so much better than those powder inhaler. I use Medicare w/ a supplmental insurance carrier. And a seperate prescription medicine w/ Humana. I beleive my inhaler is covered under my DME Durable Medical Equiptment along w. my nebulizer meds and concentratior and Bpap machine. Call your pharmacy supplier. good luck
This works for me, too... I'm concerned with how it will be handled now, because I have different (Medicare) insurance than when I got my current inhalers (which are almost depleted).
Go to the manufacturer of the Ventalon and see if they can't help with the medication. After I spend 600.00 on prescription drugs I have gotten help with my Ventalon and Advair. Go to GSK website and see what they can do.
I haven't had a problem with oxygen at home. I have Medicare and my private Ins. Always pay for my oxygen. You should have a private Ins like People's Health or an other Ins.
I'm on medicare and have humana for a supplimental coverage. It seems to handle my medications and I am on several. I use Proventil as a rescue inhaler, is that the type of med you were referring too? I pay 45.00 for a month of Spiriva which is the long acting
I went on nebulizer meds = albuterol,ipratropium bromide 4 times a day and then brovana and pulmicort in nebulizer 2 times a day and medicare pays for machine and meds. I did buy a portable nebulizer (by phillips respronic) that runs on battery or cigarette plug in car or also electrical plug which they do not pay for but at least I can be on the go more and it uses same meds which are free. I use the one medicare pays for at home and the portable when I am out. Going on the nebulizer i have been taken off advair and spiriva which were expensive.
Is it medicare part A or D prescription coverage? With part D some meds. can be prior abroved, dr. has to fill out paper work, some meds are covered under part A, my nebulizer meds. are under part A cause I use nebulizer to take them, ask pharmacy if they were denied, and if they need prior authorization? Pharmacy is supposed to contact your dr. but they usually don't, I always call my Dr and get them to do paper work, hope this helps!
I've been on it for about 20 years. I got Medicare 6 years ago and I have People's health and People's pays for it all. You should have gotten an insurance to go with Medicare. Didn't Medicare offer you Ins. to go along with it. There's usually 4 or 5 other ones you could get that's not too high. I hope you can still get one. I would suggest you talk to maybe your Medicare worker. Good luck with it all.
My experience has been the complete opposite I have 1 Ventolin inhaler which does nothing for me. As far as other meds are concerned Spirva Respimat, Trelegy are covered by my Part D provider. I was on a Medicare advantage plan and switched to a Medicare Supplement Plan for a total cost of $126/mo.
As far as the nebulizer Medicare cover all drugs used in the machine as it is considered the same as oxygen.
I know this for certain as my pulmonologist prescribed Yepelri for me just approved by FDA December 2018. A month supply of the drug is $1300 but you have to use a nebulizer for intake I was not going to continue using the drug thinking I would have to pay for it but it is covered by Medicare and my supplements. Check with you Doctors the results for most people on the drug are a tremendous improvement over any other med taken for chronic bronchitis. Check it out
I was prescribed Ventolin after receiving a letter from my RX provider said my rescue inhaler ProAir was no longer covered by Medicare. I do see a pulmonaligist, who then prescribed the Ventolin.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Challenging copd diagnosis
Cough ! Cough! Splutter!
