The Game-Changing Medicare Update for Lymphedema
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- čas přidán 18. 12. 2023
- Say goodbye to the hefty costs of lymphedema compression garments! In this video, we'll discuss how Medicare Insurance in the United States has finally started covering these expenses, thanks to the efforts of the Lymphedema Advocacy Group.
Please note this information is as of Mid-December, 2023 and subject to change, as Medicare and CMS continue to finalize details.
𝐋𝐨𝐨𝐤𝐢𝐧𝐠 𝐟𝐨𝐫 𝐋𝐲𝐦𝐩𝐡𝐚𝐭𝐢𝐜 𝐃𝐫𝐚𝐢𝐧𝐚𝐠𝐞 𝐨𝐫 𝐄𝐱𝐞𝐫𝐜𝐢𝐬𝐞 𝐏𝐫𝐢𝐧𝐭𝐚𝐛𝐥𝐞s?
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Learn more about the Lymphedema Advocacy Group:
lymphedematreatmentact.org/ab...
Links to this information:
www.cms.gov/medicare/enrollme...
www.medicare.gov/coverage/lym...
www.govinfo.gov/content/pkg/F...
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*I am a physical therapist, but not your physical therapist. Although I do monitor comments, I cannot respond to personal medical questions. Please know that these are questions for your own doctor or provider as this is general information only. Thanks!
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The content of this website, Instagram, CZcams, lectures, webinars, blogs, digital products, or other platforms does not replace the care of physical therapists or other healthcare professionals. This content is in no way to be construed or substituted as physical therapy or any other type of medical advice but is for general education purposes only. Don’t use this content to self-diagnose or self-treat any health, medical, or physical conditions. You agree to hold harmless indemnify Cancer Rehab PT, LLC and its owner/employees for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. The company cannot guarantee the outcome of educational content or recommendations on the company’s website, social media, products, blog, or email series, and Cancer Rehab PT, LLC’s, and owner, Kelly Sturm’s comments are expressions of opinion only. Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We try our best to keep things fair and balanced, in order to help you make the best choice for yourself.
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48 hours after this video went live, Medicare updated the pricing/fee schedule for DMEs and vendors. One can find it here: www.cms.gov/medicare/payment/fee-schedules/dmepos/dmepos-fee-schedule/dme24 . Please, however, continue to reach out to your local fitter, vendor, and DME provider for individualized information!
Thank you!
I hope you have a Merry Christmas
For those Medicare people who are hard-pressed to afford LE supplies, it will be a Happier New Year in the USA. Thank you to The Lymphedema Advocacy Group who worked hard on this for YEARS to push the legislation through. I donated some money and wrote to my Congressional representatives, but THEY were the ones who raised money and went to Washington DC to testify and pound on doors. Now it's real and I have tears in my eyes!
@@MossyMozart yes!!
This is such welcome news! Thank-you so much!
Kelly you are an angel!!! I am not on Medicare but that you would take the time to publish a video for those who are… it’s simply wonderful. You are so good!! He smiles on you every day.
Thank you so much for the kind words! They really made my day 🙂
I am just at the beginning of watching this video, but I already can tell it will be amazingly informative. You do such a great job of presenting yourself and your skills, and you do a great job on our behalf. Thank you so very much for your professionalism and generosity.
🙋✝️🧡🕊️🙏
Ah thank you so much for such kind words 😊 It means a lot to me!
I suffered 4 years, going through two surgeries, but not finding relief. After seeing your video, I do have post breast cancer surgery lymphedema and am not getting treated by a lymphedema specialist. The validation itself has really helped me.
I have shared your videos with my therapist!!!
Excellent and helpful....genuinely appreciated.
Thank you for this update. I helped to fight for this bill to be passed.
Thank you for fighting for it! It truly made a difference
Thank you for this information.
2 yrs ago I was diagnosed with breast cancer and went for mastectomy. I am very thankful that by chance I came to know this channel to understand about lymphedema. Thank you & may God bless you for all your efforts to help others.
Thank you for the kind words! Bringing awareness was truly my purpose for creating these videos 🙂 I hope all is well for you!
That is wonderful news! My equipment that was somewhat covered by private insurance 2 yrs ago is wearing out. Amazing how little some oncologist know about a condition that impacts the lives of those they save! Very grateful to have found this channel. I am also interested in the research and updates on mapping? Pinpointing a more effective and individualized route if I recall correctly. 3 yrs out from breast cancer and 7 years clear from lung cancer 🎉Thank you for all your hard work and expertise. ❤
Absolutely it is! And I think I know what you’re referring to- I speak about that topic in this video, along with a few others if you haven’t seen it yet and want to learn 🙂 The Future of Lymphatic Drainage: Revolutionizing Lymphedema Treatment
czcams.com/video/UzSi_C2BA_M/video.html
@@CancerRehabPT❤
Thank you for sharing this information, as it is truly a change for the better for lymphedema patients.
It absolutely it!
That's awesome. Great for us
Many thank yous, Kelly for a wonderful explanation of the new Lymphedema Law. I was very impressed with the way you presented the facts and informed me how to best take advantage of this new legislation. I did have prior knowledge of some of the provisions but thanks to you I now have formulated a new "game plan" to obtain the garments and supplies I need to best treat this disease. You are a treasure!
Oh thank you so much for you kind words and feedback. I’m so glad to hear you found it so helpful and that you have a “game plan” 🙂
Thanks for your help, appriciated
A patient told me this. The next big news would be if insurance recognizes massage therapists who are CLTs and.did the required training. I have people coming to me and paying out of pocket because they can't find available CLTs who are PTs/OTs.
Excellent information! Thank you for sharing. Enjoy a blessed Christmas 🙌
Thank you! You as well! 🙂
So helpful ❤
Thank you Kelly! This has been a long long fight! I've called my congressman, spoke to Rand Paul, I could go on and on. Unfortunately Kelly I have it pretty bad but, I'm not on medicaid or any Medicare. So .. looks like my fight is not over. I have the machine. I watch you always I appreciate everything you do and teach me
I will see what they ended up naming the law. So I can look into this further. I really need these items
Thank you & stay blessed Have a wonderful Christmas
Thank you for all that you did for this! I’m sorry you still have a lot to deal with, but what I do know is that this community isn’t done fighting for what all of those who have lymphedema and other lymphatic conditions need. Sending you my best!
@@CancerRehabPT I totally agree! I had the papers on Mich McConnell desk! Seriously
Did Rand Paul vote yes on this bill?
@lisanoell Yes he did
I am trying to remain hopeful about this Medicare coverage, however, I have heard from my local supplier that if the Medicare approved amount is not sufficient, they will not be offering coverage for all garments.
Ugh. That’s still a concern, yes. Although this was a large, first step we know there is work to be done - which we’ll continue to fight for!
Thanks!
Please make videos radiation pain and stiffness on inguinal area involving thigh, suggest best exercise, Thank u
Wow 😲
Do they cover for lipedema
Are prescribed compression knee highs going to be covered also?
Kelly what has your experience been at this point with coverage and reimbursement?
As a clinician, so far this has not been good.
DME providers that we work with are now not willing to continue with the Medicare submissions since the process is very slow and coverage has not been provided. They are dealing with products orders given out and compensation not being received. More of them are reverting back to private pay first due to this.
It’s great that Medicare has made this long overdue ruling. However, currently it is coming across as false hope from the providers and clinicians are dealing with the brunt of frustration from patients in delay of care. Which then imposes additional layer of challenges in the clinic with insurance coverage for prolonged treatment visits.
What have you dealt with so far?
Yes, most DMEs in my area are confused and unsure, so they are having patients self-pay to start with the goal of being reimbursed. Not ideal, but it was expected. We were explained by a consultant with the LTA that this was a process and the first few months were going to be more of a test run with those going through. hopefully it’ll start to play itself out in the next few months to get an idea of how DME’s will operate
Hmmm. You might want to slightly revise the message on the posting image for this video. Medicare is not paying for lymphedema; it is paying for lymphedema treatment.
Thank goodness! .^_^.
You have not said anything about the lymphedema pump. Can you please tell about that too
@sulabhanarvenkar730 - The Doctor has a video specifically about using a pump. If you are wondering about paying for one, I went to the Lymphedema Clinic at Memorial Sloan Kettering Cancer Center in MYC. They arranged for me to get a pump at no cost to me about a year ago. I don't know exactly how payment worked, but I was never billed. I have (Medicare Plan F.)
@@MossyMozart
Thanks a lot! I was wondering if Medicare will cover the cost!!
This will help a lot.
It truly will help so many
Suffering from lung cancer which has spread from my mouth, will be going through cemotherapy.Myquestion is how to minimise the side effects of cemo.
Marional helps you can get it from your PCP! Also I'm not sure if you have the machine but it work's you will still need compression garments though I found out dyred apricot seeds help. I'm gonna give it a go who knows. I think I'll have a hard time since I independent insurance I have stage 4 metastatic breast cancer her2 triple positive hormone fed and estrogen resepters aggressive. Certainly all that fight wants for nothing. Oh you can get Lidocaine prescribed that really helps with your mouth
If I can give you any advice that I may know please tag me Stay Blessed
I want to know what is lymphedema ?
It’s a horrible condition when lymph nodes have been surgically removed or otherwise compromised. Lymph fluid can’t drain properly and starts to pool and backup causing swelling. It requires lifelong management so we don’t end up losing an affected limb to cellulitis. I hope you will never have it.
@@chccooperider1377 - It can also be caused by radiation damage and other trauma and it can be a genetically acquired condition, too. It is a progressive disease that can lead to more and more swelling if left without treatment and can cause tissue fibrosis. It can effect any body region - legs, arms, genitalia, abdomen, and the head.. At its worst, the pooling fluid can cause fatal infections in the tissues.
Is Medicaid at all related to Medicare or not?
Medicaid is coverage from the government like MediCate is, but Medicaid is for very low income earners, while MediCare is for Seniors. The plans are not the same either.
@@lisanoell thank you. I was told by my OT that the compression wraps for people with lymphedema are actually dangerous and you don't want to have one on, if you can avoid it. Is this an old superstition or something? Is there any evidence for what she said?
@@investorjeremymetcalftake what I say with a grain of salt bc I just received my diagnosis last month and this is all new to but my lymphie coach and my cardiologist both recommend them compression wraps. It’s considered a key pillar in Lymphedema care by the the majority of Lymphedema specialists as I understand it. But I think you do need to learn when to use them and how to do it safely, I think. That is why it’s important to have a certified specialist who can educate you. So I haven’t started using them yet but I expect to give it a try once I get trained in it. Is your OT specially and extensively trained and certified for Lymphedema? I would like to know the evidence she has that lead her to say that. I haven’t seen evidence for or against but I haven’t looked into that yet. It’s a new world to me.
@@investorjeremymetcalf - This Doctor definitely advocates for wraps using short-stretch bandaging. This is NOT the same as Ace bandages - they could be dangerous. And why are you seeing an Occupational Therapist anyway and not a certified Lymphedema Physical Therapist?
This woman has a ton of videos on what supplies to use and how to apply them. (NOTE: There is new research about how to do Manual Lymphatic Drainage. For instructions on that technique, watch her MOST RECENT videos on it.)