A persistent cough can be annoying. Whether you clear your throat frequently throughout the day interrupting meetings and conversations, or have a prominent cough that leaves you fatigued and lightheaded, a chronic cough may be more than just an aggravation. Learn more about chronic coughs, when you should call your doctor, and whether your medical expenses will be covered by your Medicare plan.
What is considered a “chronic cough?”
Many of us notice an occasional cough, or one that lingers long after a common cold has gone away. Most of the time, it will subside within a week or two. If your cough lasts more than eight weeks, or is accompanied by vomiting, fatigue, dizziness, headaches, loss of bladder control, or chest pain, it might be time to call your physician.
Causes of a Chronic Cough
A cough can sometimes just be the result of your body’s natural response to an irritant or infection, but it can also be caused by a number of underlying medical issues, including, but not limited to:
- Asthma – Asthma-related coughs may be seasonal or induced by allergies, exercise or activity.
- Gastroesophageal reflux disease (GERD) – Caused by stomach acid flowing back into the esophagus, irritation can cause chronic coughing.
- Infection – The flu, pertussis, pneumonia, or other respiratory infections can be the cause of a lingering cough.
- Bronchitis – Continued inflammation of the bronchial tubes can cause coughing in current and past smokers; smoking-related diseases can also include COPD (chronic obstructive pulmonary disease) and emphysema.
- Medications – Medications to treat blood pressure (ACE, or angiotensin-converting enzyme, inhibitors) can cause chronic coughing.
- Upper Airway Cough Syndrome (UACS) – Postnasal drip can trigger your cough reflex.
Less common causes of a chronic cough can include lung cancer, cystic fibrosis, and sarcoidosis.
Diagnosis and Treatment of a Chronic Cough
When you visit your doctor’s office to discuss your chronic cough, take a list of your current medications and your family medical history information. After discussing your symptoms, your doctor may suggest imaging tests to screen for disease, including:
- CT scans
- Lab tests
Chest X-rays can be used to check for lung cancer, pneumonia or other lung diseases, while an X-ray of the sinuses can indicate a sinus infection. CT (computerized tomography) scans can help diagnose other lung or sinus conditions. Scopes using a thin, flexible tube inserted by a physician with a light and camera attached can detect abnormalities and samples of tissue extracted through a biopsy can be sent to a lab for a pathologist to examine.
Treatment for a chronic cough will vary depending on the diagnosis, but can include over-the-counter and prescription medications, such as:
- Antihistamines and decongestants
- Inhaled asthma medications
- Acid blockers
- Cough suppressants
How Medicare Can Help
With the potential doctor visits, tests, and medications needed to diagnose and treat a condition accompanied by a chronic cough, you may be worried about the out-of-pocket medical expenses you may incur. Medicare can help alleviate some of your stress.
Medicare Part B, sometimes referred to as Medical Insurance, will cover any medically necessary services or supplies needed to diagnose or treat a medical condition, as long as it meets accepted standards of medical practice. If you are enrolled in Part B, you will pay an annual premium and deductible.
If you have Original Medicare, you will need to visit a physician that accepts assignment. A doctor that accepts assignment has contracted with Medicare to be paid directly by Medicare, to accept the payment Medicare has approved for the service, and has agreed not to bill you for more than the Medicare deductible and coinsurance. After your Part B deductible is paid, you will likely pay 20% of the cost of the Medicare approved amount of doctor services and outpatient therapy.
Original Medicare helps cover many medical expenses, but many Medicare recipients supplement their Medicare insurance by purchasing a Medigap policy. Medigap helps pay costs Original Medicare does not, including coinsurance, copayments, and deductibles. Unfortunately, prescription drugs are not covered by Original Medicare or Medigap. If you require prescription medications to treat your chronic cough or an underlying medical condition, you will want to consider enrolling in a stand-alone Prescription Drug Program (PDP).
If you are enrolled in a Medicare Advantage plan, you may have an HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), Private Fee-for-Service Plan, Medical Savings Account, or Special Needs Plan (SNP). If you belong to an HMO or SNP, you will usually have to visit a doctor within your plan’s network. If you visit a doctor outside of the network, you may be responsible for all your medical expenses. If you have a PPO plan, you may be able to visit a provider outside of the network for a higher cost.
Medicare Advantage plans must offer the same benefits at Original Medicare, but many offer additional ones, including prescription drug coverage. A Medicare Advantage plan with prescription drug coverage (MA-PD) may help pay some of the costs of prescription drugs prescribed by your doctor to treat a chronic cough or an underlying illness.