End-Stage COPD: Symptoms, Treatment and Medicare Coverage

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.

Woman walking with her dog

Symptoms of end-stage COPD

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

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 and Medicare Advantage (Part C) plans with prescription drug coverage can provide coverage for opiates, bronchodilators and glucocorticoids.

Complementary therapies are not covered by Original Medicare, but certain therapies may be covered by a Medicare Advantage plan. 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.

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

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