Does Medicare cover QVAR? 

Asthma is a chronic condition that makes breathing difficult, causing inflammation and narrowing the airways in your lungs. Asthma can be an affliction at any age, often beginning during early childhood. According to the Centers for Disease Control and Prevention (CDC), 7.8% of adults 65 and over have this long-term condition.

Symptoms and treatment

If you have asthma, you may experience coughing, wheezing, shortness of breath and chest tightness. Asthma symptoms usually follow a specific pattern. Symptoms stop and start throughout the day. They worsen at night, in the morning and when you have a viral infection like a cold. Symptoms often appear after exercise, laughing, crying and allergic reactions. 

Though there is no cure for asthma, treatments are available to help you manage the symptoms. A typical asthma action plan includes medication, monitoring and avoidance of triggers. Any substance or event that makes symptoms worse is called an asthma trigger. Examples of asthma triggers include air pollution, dust mites, mold, pests, pets, smoke, chemicals and cleaning products.

Doctors often prescribe inhalers and nebulizers, devices that deliver medication to the lungs, for patients with asthma or chronic obstructive pulmonary disease (COPD). An inhaler is a handheld machine that pushes puffs of medicine, sometimes in metered doses. A nebulizer delivers medication by spraying a mist using a mouthpiece or mask.

Medicare coverage for QVAR RediHaler

A rescue inhaler is designed for quick relief if you have an asthma attack. QVAR RediHaler (beclomethasone) is an inhalation aerosol designed for maintenance twice per day to reduce inflammation in your lung’s airways and mitigate the need for a rescue inhaler.

Medicare Part D covers prescribed drugs. Part B, durable medical equipment (DME), covers devices like nebulizers and nebulizer medication. The DME benefit is for medically necessary equipment your healthcare provider orders for home use. Medicare will only pay DME benefits if you use a prescribing doctor and supplier who enroll in Medicare.

Healthcare providers and suppliers who enroll and participate in Medicare are contractually required to accept assignment. Non-participating providers and suppliers do not have to agree with the Medicare-approved amount for the DME you purchase or rent. If Medicare approves the equipment you get from a participating provider, your cost-sharing is 20% of the Medicare-approved amount and the Part B deductible.

The manufacturer, Teva Respiratory, offers a savings card to patients not covered for the QVAR device by Medicare or Medicaid. If your QVAR is not approved, you can apply for the savings card on the manufacturer’s website. 

Where to get more information

You can find details about the QVAR RediHaler on the manufacturer’s website. For user-friendly information about asthma, check online resources like the National Heart, Lung and Blood Institute (NHLBI) and the American Lung Association.

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