End-Stage COPD: Symptoms, Treatment and Medicare Coverage

What is End-Stage Chronic Obstructive Pulmonary Disease (COPD) and what are the symptoms? Learn more about COPD treatment options, and find out if Medicare can help cover your costs.

Chronic Obstructive Pulmonary Disease (CPOD) refers to several progressive lung diseases such as emphysema, chronic bronchitis and refractory asthma. People with COPD develop increasing breathing difficulties as the disease progresses.

End-stage COPD refers to stage 4, or the final stage of the disease.

Symptoms of end-stage COPD

The most common symptom of end-Stage COPD is a significant shortness of breath, even while you’re resting.

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Additional symptoms of COPD may include:

  • Chronic cough
  • Difficulty eating due to shortness of breath
  • Frequent phlegm production
  • Low blood oxygen levels
  • Confusion or decreased alertness due to reduced oxygen flow to the brain
  • Swelling of the extremities
  • Loss of weight and muscle strength
  • Difficulty speaking
  • Blue or gray tinge on lips and fingertips
  • Rapid heartbeat
  • High risk of lung infections and respiratory failure

There is no cure for COPD.

Many people may associate the term “end-stage” with imminent death, or they may think there is nothing more that can be done. But “end-stage” simply means that the disease is as bad as it will get and has little-to-no room for progression.

“End-stage” should not imply impending death. There are typically still treatment options for someone with COPD, even during the final stage.

What are the stages of COPD?

The four stages of COPD are:

  • Stage 1 (Mild COPD): Lung function begins to decline but there may not be any noticeable symptoms.

  • Stage 2 (Moderate COPD): Symptoms form or progress

  • Stage 3 (Severe COPD): Symptoms worsen

  • Stage 4 (End-Stage): Very severe COPD in which quality of life is low and the condition can become life threatening

How is end-stage COPD treated?

Treatment for end-stage COPD typically involves palliative care to relieve symptoms. The most common treatment options are listed below.  

Prescription drugs

Some of the prescription drugs used to treat end-stage COPD include bronchodilators and glucocorticoids, which are administered through an inhaler. These substances dilate the bronchi (airways that conduct air to the lungs) and reduce inflammation to allow a wider passageway for air to travel through.

Opiates like morphine may also be used to improve shortness of breath.

Supplemental oxygen

Supplemental oxygen may be pumped into the lungs to improve breathing and boost blood oxygen levels.

Noninvasive ventilation

Noninvasive ventilation involves the use of a ventilator mask that pumps oxygen-rich gasses into the airway. This is in contrast to invasive ventilation, which involves the use of a breathing tube or any other instrument that penetrates the mouth, nose or skin (such as a tracheostomy tube).

Pulmonary rehabilitation

Pulmonary rehabilitation is a program that can consist of exercise training, nutritional counseling, psychological counseling and education in energy-conserving techniques and breathing strategies.

Complementary therapies

Complementary therapies can involve relaxation and visualization techniques, therapeutic massage and music therapy to help soothe breathing difficulties.

Does Medicare cover end-stage COPD treatments?

Medicare Part B medical insurance provides coverage for pulmonary rehabilitation for people with moderate to severe COPD. The rehabilitation may occur in a doctor’s office or hospital outpatient setting.

You will need a referral from the doctor who is treating your COPD in order for Medicare Part B to cover your pulmonary rehabilitation.

Oxygen, noninvasive ventilation and related supplies and accessories are also typically covered under Medicare Part B, as these items qualify as “durable medical equipment” (DME). A doctor must first prescribe the use of oxygen.   

Medicare Part D plans can provide coverage for opiates, bronchodilators and glucocorticoids.

A Medicare Advantage plan can cover benefits not covered by Original Medicare. Coverage can vary from plan to plan, so be sure to check with your Medicare Advantage plan provider to find out if your treatment is covered by your plan.

Speak to a licensed insurance agent to learn more about how a Medicare plan can help cover your End-Stage COPD treatments.

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.


This article is for informational purposes only. It is not healthcare advice. Speak to your doctor or healthcare provider about your specific healthcare needs.


About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

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