Does Medicare Cover Laser Ablation Surgery For Seizures
Thermal ablation is known as interstitial thermal therapy. Medicare doesnt have a National Coverage Determination for laser interstitial thermal therapy. Also, Local Coverage Determinations dont exist either.
Yet, Medicare usually covers medically necessary services and procedures. So, if your doctor says you need interstitial thermal therapy, its likely that Medicare will cover. Now, if you have a Medicare Advantage plan, coverage will likely vary.
Find Medicare Plans in 3 Easy Steps
We can help find the right Medicare plans for you today
How Does Deep Brain Stimulation Work
Movement-related symptoms of Parkinsons disease and other neurological conditions are caused by disorganized electrical signals in the areas of the brain that control movement. When successful, DBS interrupts the irregular signals that cause tremors and other movement symptoms.
After a series of tests that determines the optimal placement, neurosurgeons implant one or more wires, called leads, inside the brain. The leads are connected with an insulated wire extension to a very small neurostimulator implanted under the persons collarbone, similar to a heart pacemaker. Continuous pulses of electric current from the neurostimulator pass through the leads and into the brain.
A few weeks after the neurostimulator has been in place, the doctor programs it to deliver an electrical signal. This programming process may take more than one visit over a period of weeks or months to ensure the current is properly adjusted and providing effective results. In adjusting the device, the doctor seeks an optimal balance between improving symptom control and limiting side effects.
What Happens After Deep Brain Stimulation
Your healthcare provider will schedule a follow-up appointment that will take place within a few weeks of the pulse generator implantation procedure. At this appointment, they’ll start programming the pulse generator.
All pulse generators now in use have a wireless antenna built-in. That allows your healthcare provider to access and program the device from outside your body. Finding the right settings for the pulse generator may take some time and additional visits for adjustments.
Most pulse generators have special batteries that have long lifespans. Standard batteries for these devices last about three to five years. Some devices use rechargeable batteries, which can last about nine years. Replacing the battery also takes a surgery procedure, but this is usually shorter and quicker than the original surgery to implant the pulse generator. You’ll still go home the same day for battery replacements.
Read Also: Where Do I Get A Medicare Card
Does Medicare Cover An Eeg Or Electroencephalogram
An Electroencephalogram can be done to diagnose and treat epilepsy. The non-invasive test can show the region of the brain that has abnormal activities.
Since this is a diagnostic lab test, Medicare will cover the full cost. Also, Medicare Advantage plans should provide full coverage when this is necessary for diagnosis or treatment.
Placement Of The Neurostimulator
This procedure takes place under general anesthesia so that the person is asleep. The surgical team inserts the neurostimulator under the outer layers of skin, usually just under the collarbone, but sometimes in the chest or abdomen. The extension wire from the lead is attached to the neurostimulator.
You May Like: How To Apply For Medicare Card Replacement
Will Dbs Be Covered
Most public and private health insurance companies, including Medicare, cover approved uses of deep brain stimulation, including essential tremor treatment. If you’re concerned about therapy coverage, talk with your doctor’s office and insurance company. You can also ask your clinic for a cost estimate.
What Are The Advantages Of Deep Brain Stimulation
DBS has several advantages. These include:
- It can offer a treatment option when medications arent helpful: DBS is an option when medications don’t work or are no longer effective. With Parkinsons disease, medications lose effectiveness over time, so your healthcare provider has to increase your dosage. That leads to other side effects. With DBS, lower medication dosages are often effective again, which means your symptoms are under control with reduced side effects.
- It can be a life-changing treatment: Some of the conditions that DBS treats can cause severe effects that keep you from doing even the most routine activities. DBS can treat your condition and improve your symptoms, improving your overall quality of life. For conditions like medication-resistant epilepsy, where surgical resection isn’t an option, DBS can offer hope and reduction in seizure frequency.
- Its adjustable: Your healthcare provider can fine-tune the pulse generator settings to find what works best for you.
- Its reversible: A follow-up surgery can remove the leads and pulse generator if DBS doesn’t work or causes side effects that you can’t tolerate.
Also Check: How To Reorder Medicare Card
How To Get Extra Medicare Coverage For Epilepsy
Our team of Medicare agents can help you find the best plan for your budget and health needs.
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 option.
Give us a call today at the number above. If you cant call, fill out our online rate comparison forms.
- Was this article helpful ?
Medicare Coverage For Parkinsons Disease
- Medicare covers medications, therapies, and other services involved treating Parkinsons disease and its symptoms.
- Physical therapy, occupational therapy, and speech therapy are all included in this coverage.
- You can expect some out-of-pockets costs, even with your Medicare coverage.
Medicare covers medically necessary treatments for Parkinsons disease, including medications, different types of therapy, and hospital stays. Based on the type of coverage you have, you may have some out-of-pocket expenses, such as copays, coinsurance, and premiums.
Medicare may not cover all of the services youll need, such as assistance for normal daily living.
If you or a loved one has Parkinsons disease, its important for you to understand which parts of Medicare cover which treatments to avoid large, unexpected expenses.
Also Check: Does Medicare Cover Keloid Removal
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.
Why Is Dbs Used
There are billions of neurons in each human brain, and these cells communicate with each other using electrical and chemical signals. Several brain conditions can make neurons in different parts of your brain less active. When that happens, those parts of your brain dont work as well. Depending on the part of the brain affected, you can have disruptions in the abilities controlled in that area.
DBS uses an artificial electrical current to make those neurons more active, which can help with the symptoms of several different brain conditions. However, researchers still dont know exactly how or why this works.
You May Like: Is Medicare Advantage The Same As Medicare Supplement
Does Medicare Cover Epilepsy
Original Medicare covers care for people with epilepsy. Coverage includes diagnostics, treatment, hospital, and medical care. Part A covers inpatient surgeries. But, outpatient doctor bills fall under Part B.
Then, Part D plans cover epilepsy medications. Good healthcare is critical for epilepsy patients and treatment is specific to the individual. Lets take a look at the specifics of Medicare for those with epilepsy.
Which Neurological Disorders Does Medicare Cover
Original Medicare covers medically necessary therapeutic treatments, surgeries, blood transfusions and diagnostic tests for many neurological disorders.
According to the World Health Organization , neurological diseases affect hundreds of millions of people worldwide. Below are some examples of common neurological disorders affecting Medicare beneficiaries.
Common Neurological Disorders
Though these neurological disorders dont have cures, Medicare covers many treatments to improve symptoms and quality of life.
Have you selected your 2023 Medicare plan?
Also Check: Is Teeter Inversion Table Covered By Medicare
How To Prepare For Surgery
Before the DBS treatment, the patient is advised to undergo various tests to carefullyevaluate whether DBS is a good option for the patient or not. These tests assess the thinking and memory status of the patient. A psychiatrist may also examine the patient to determine if there is any prevailing medical condition like anxiety or depression. In which case the patient may require to be treated before going for the DBS surgery. The selection of a patient for this procedure is usually a multidisciplinary process that involves a neurosurgeon, a movement disorder neurologist and a neuropsychiatrist.
It is also important for the doctor to ask if the patient has any dietary restrictions, is taking medications or smokes, for example.
Stereotactic Dbs Vs Interventional Image
Stereotactic DBS surgery requires the patient to be off their medication. During the procedure, a frame stabilizes the head and provides coordinates to help the surgeons guide the lead to the correct location in the brain. The patient gets local anesthesia to keep them comfortable throughout each step along with a mild sedative to help them relax.
During image-guided DBS surgery, such as with interventional MRI or CT scan, the patient is often asleep under general anesthesia while the surgeon uses images of the brain to guide the lead to its target.
Some advanced centers offer both the stereotactic and iMRI-guided options for DBS surgery. In this case, the doctor and patient will discuss which procedure is better based on a number of factors.
For instance, the doctor may recommend an image-guided procedure for children, patients who have extreme symptoms, those who are especially anxious or fearful or those whose leads are going into certain parts of the brain.
Generally, DBS surgery follows this process:
You May Like: Are Synvisc Injections Covered By Medicare
How Does Deep Brain Stimulation Work In Parkinsons Disease
Parkinsons disease causes uneven electrical signals in some brain areas that control movement activities. DBS utilises electrical stimulation to control these control centres deep to the surface of the brain. This enhances the communication between the brain cells. It also helps to decrease symptoms such as slowness, tremor, and stiffness.
When Should I Call My Healthcare Provider Or Go To The Hospital
Because DBS involves surgery especially the procedure on your brain there are some warning signs you shouldn’t ignore. You should call your healthcare provider immediately or go to the hospital outside of business hours if you have the following symptoms:
- Severe headache that happens suddenly or wont go away.
- Bleeding from your incisions.
Also Check: Does Medicare Pay For Medical Alert Bracelets
How Medicare Covers These Treatments
Traditional Medicare has two parts. Part A supplies hospital coverage. It will pay for your inpatient stay in the hospital as well as up to a hundred days in a skilled nursing facility. If someone with Parkinsons pursues inpatient surgery like DBS, Part A pays for this.
Outpatient treatments are covered under Medicare Part B. While this includes expected things like doctor visits and lab work, Part B also covers more costly services such as outpatient surgery, CT scans, injectable medications, durable medical equipment and physical therapy. It will cover the cassettes used with a Duopa pump and any diagnostic imaging necessary before these types of procedures.
For nearly 50 years, Medicare had no coverage for outpatient retail medications. However, all of this changed in 2006 with the advent of Medicare Part D. Part D is optional drug coverage for people who are eligible for Medicare and are enrolled in either Part A and/or Part B.
Part D is critical for any person living with Parkinsons. Most Part D plans cover Carbidopa/Levodopa as well as other common medications used in the treatment of Parkinsons. All Medicare beneficiaries will have an opportunity to enroll in Medicare Part D when they first become eligible for Medicare, and there are no pre-existing condition limitations.
Does Medicare Part D Cover Drugs For Epilepsy
Part D will cover Medications for many conditions. But, its your responsibility to make sure your medications are on the formulary.
Epilepsy patients rely on medications to control and limit epileptic seizures. Numerous antiepileptic, or anticonvulsive, drugs are available. Different medications are effective for different people, and side effects can vary.
Further, anticonvulsants for epilepsy are among six classes of drugs protected under Part D. All plans must cover the drugs in protected classes. Patients must have the right to seek all medications available to treat their condition.
While there are protections to keep these medications available, there are barriers to care including high cost-sharing that can limit access to lifesaving medications. Now, the Low-Income Subsidy or the Extra Help program can help low-income beneficiaries gain access to medications.
Recommended Reading: How Does Bernie Sanders Pay For Medicare For All
What Is The Outcome For The Patient How Long Do The Effects Of Deep Brain Stimulation Last
Subthalamic nucleus deep brain stimulation offers long-term improvements in motor function for Parkinsons disease . This does not stop the neurodegenerative processes of PD. As such, quality-of-life scores have also fallen.
Long-term outcomes of DBS are precision of electrode targeting, patient selection, medication adjustments, and experienced stimulation.
Medicares Coverage Of Neurological Disorder Treatments
Many treatments for neurological disorders like Parkinsons disease and Alzheimers disease are covered by Original Medicare, Medicare Advantage and Part D plans. If you require additional coverage, you might qualify for a Special Needs Plan .
- Written by
Lindsey Crossmier
Financial Writer
Lindsey Crossmier is an accomplished writer with experience working for The Florida Review and Bookstar PR. As a financial writer, she covers Medicare, life insurance and dental insurance topics for RetireGuide. Research-based data drives her work.
-
Savannah Hanson
Senior Financial Editor
Savannah Hanson is a professional writer and content editor with over 16 years of professional experience across multiple industries. She has ghostwritten for entrepreneurs and industry leaders and been published in mediums such as The Huffington Post, Southern Living and Interior Appeal Magazine.
Our fact-checking process starts with vetting all sources to ensure they are authoritative and relevant. Then we verify the facts with original reports published by those sources, or we confirm the facts with qualified experts. For full transparency, we clearly identify our sources in a list at the bottom of each page.
APACrossmier, L. . Medicares Coverage of Neurological Disorder Treatments. RetireGuide.com. Retrieved December 2, 2022, from https://www.retireguide.com/medicare/treatments/neurological-disorders/
Content created by RetireGuide and sponsored by our partners.
Key Principles
Read Also: Is Everyone Eligible For Medicare
What Conditions And Symptoms Can Dbs Treat
DBS can treat several conditions that affect your brain, including movement disorders, mental health conditions and epilepsy.
DBS has approval from the U.S. Food and Drug Administration to treat the following conditions:
It’s important to keep in mind that while the above conditions might benefit from DBS, experts still don’t know if this is the case. It usually takes years of research and clinical trials to determine if a medical procedure like DBS is helpful for conditions like these. While researchers are looking into them, DBS surgery to treat these conditions is not common.
What To Expect What Is The Recovery Time
Some side effects can be expected, but the surgery is not very painful. In the weeks and months after DBS surgery, patients may observe some side effects. This depends on the initial programming and medications involved. The side effects may be numbness, abnormal sensations, tingling, and involuntary muscle contractions. Most of the patients may also feel some degree of discomfort due to the implantation of the neurostimulator. However they get used to it over time.
The recovery period post-surgery is quite short. Many patients can return to their normal daily activities in very little time while they co-ordinate with doctors to program the device. Apart from mild pain in the initial days after treatment that can be treated with some pain-killers, patients do not experience much pain.
Read Also: Can A Person Qualify For Medicare And Medicaid
Who Is A Candidate For Deep Brain Stimulation
DBS is more than just a surgical procedure. It involves a series of evaluations, procedures, and consultations before and after the actual operation, so people interested in being treated with DBS should be prepared to commit time to the process.
For example, those who do not live close to a medical center that offers DBS surgery may need to spend significant time traveling back and forth to appointments.
The procedure, as well as the pre-operative evaluation and post-operative follow-up, can be expensive depending on the persons insurance coverage. DBS surgery is an FDA-approved treatment for Parkinsons disease, and Medicare and most private insurers cover the procedure, but the extent of coverage will depend on each persons individual policy.
Prospective patients should have realistic expectations about DBS results. Although DBS can improve movement symptoms of Parkinsons disease and greatly improve quality of life in properly selected patients, it is not likely to return anyone to perfect health.
Will Medicare Pay For In
Medicare usually does not provide non-medical home services such as cooking or cleaning or personal care like bathing and dressing. Medicare generally will only cover in-home health care services if your Medicare doctor recommends intermittent skilled care in a face-to-face meeting with you.
You must be homebound and unable to leave your home without special equipment. You must also receive care from a home health agency that is certified by Medicare.
If you meet these qualifications, then Medicare may cover limited home health care services as well as in-home physical therapy, durable medical equipment and medical supplies provided by the home health agency.
Danielle Kunkle Roberts is a member of the Forbes Finance Council and is the co-owner ofBoomer Benefits, where her team assists Medicare beneficiaries with their supplemental benefit options in 47 states.
Also Check: Who Is Eligible For Medicare Part B Reimbursement
