16 May New Coverage for Lymphedema Through Medicare
If you have had cancer treatment that has caused lymphedema and you have Medicare, then this blog is for you.
What is Lymphedema?
Lymphedema refers to swelling caused by fluid that accumulates, instead of being drained through the body's lymphatic system. Lymphedema usually affects arms or legs, but can also occur in the chest wall, abdomen, neck, and genitals.
Lymphedema can be caused by cancer treatments that remove or damage your lymph nodes.
Between 1.5 and 3 million people who have Medicare, also experience lymphedema.
How is Lymphedema treated?
Compression garments are important in treating lymphedema. The most effective treatment for lymphedema is Decongestive Therapy or “CDT.” Compression garments are an essential component of CDT.
These garments improve patients’ quality of life by reducing infection and other complications. Importantly, they also prevent patients’ symptoms from becoming worse.
Despite their medical benefits, compression garments have not been consistently covered by Medicare. As a result, many lymphedema patients have been unable to afford them.
What is the Lymphedema Treatment Act?
After many years of advocacy efforts, on December 23, 2022, Congress passed the Lymphedema Treatment Act, to make compression garments more accessible to lymphedema patients.
Passed with strong bipartisan support, the law expands Medicare Part B coverage to include:
- Standard and custom-fitted gradient compression garments that are prescribed by a doctor to treat lymphedema; and
- Other devices determined to be effective in the prevention or treatment of lymphedema.
The new law will go into effect on January 1, 2024.
For the full text of the law, visit S.1315 – Lymphedema Treatment Act.
For more information about navigating health insurance, visit our Health Insurance Topics Page.
About Triage Cancer
Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through events, materials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.
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