Medicare coverage for LE?

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Jiffrig
Jiffrig Member Posts: 232
edited September 2016 in Lymphedema

What are the limitations on Medicare for treatment of lymphedema? Do they cover any therapy

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  • ChiSandy
    ChiSandy Member Posts: 12,133
    edited September 2016

    If a physician diagnoses you with stage 0 (or above) lymphedema, medical consultations with a lymphedema specialist and a limited number of physical therapy sessions per year are covered. Compression garments, bandages and pumps are not. (By contrast, anyone who has had a “mastectomy”--and even the smallest lumpectomy is defined as a partial “mastectomy”--is entitled to one pair of prostheses every two years and two specialty bras to hold them per year, whether we need them or not). This is a situation the Lymphedema Treatment Act was introduced to correct. It has bipartisan sponsorship and broad bipartisan support in both houses of Congress. But it is being held hostage in committee as a pawn in exchange for agreeing to totally unrelated stuff like de-funding Planned Parenthood, corporate tax cuts, voting restrictions, cuts in social service safety nets, privatizing Social Security and Medicare and busting unions.

  • Binney4
    Binney4 Member Posts: 8,609
    edited September 2016

    Just to add a note to ChiSandy's very helpful post: If you're dealing with truncal lymphedema those two mastectomy specialty bras can certainly be compression bras or camis, so you can get your truncal compression garments through Medicare as long as they also accommodate prostheses. For instance, I get two WearEase compression camis called "Slimmers" per year which are coded as mastectomy bras because they have prosthesis pockets. (Four a year would be a lot better, but WearEase often has good sales and discounts which I also take advantage of.)

    We do what we can! ;-)

    Be well,
    Binney


  • Jiffrig
    Jiffrig Member Posts: 232
    edited September 2016

    Thanks everyone for the info. I am certain I will be a victim of LE as I have one lymph node involved and want to be sure to stay on top of this as best I can. Doing chemo now and then bmx and radiation to lode(s). At my age(67), with fleshy upper arms, I don't stand a chance of escaping I'm afraid. So much fun...😜

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