Approximately 4 million people have been diagnosed with fibromyalgia, a medical condition that causes widespread musculoskeletal pain throughout the body, along with severe fatigue, anxiety, depression, headaches. It causes pain in the muscles, ligaments, and tendons. Although fibromyalgia can affect anyone, you may be at a higher risk due to:

  • Age
  • Sex
  • Previous diagnosis of lupus or rheumatoid arthritis
  • Family history
  • Obesity
  • Repetitive injury
  • Traumatic event

Older adults, especially women, are more likely to experience fibromyalgia, but if you are experiencing any symptoms, talk to your doctor. Blood tests, x-rays, and a physical exam can lead to a diagnosis and treatment.

Treating Fibromyalgia

Fibromyalgia can be managed with medication, but a rheumatologist can work with you to design a custom strategy to combat your symptoms. Rheumatologists specialize in diseases that can affect your muscles, joints, and bones, including arthritis, autoimmune diseases, lupus, and fibromyalgia. Your physician may suggest certain exercises to strengthen your muscles, stress management techniques such as yoga and meditation, and better sleep habits. If there are accompanying conditions, your medical team will coordinate your treatment and care.

Medicare Coverage for Fibromyalgia Treatment

Medicare can help cover the costs of your treatment of fibromyalgia. Medicare Part B (Medical Insurance) can help cover the costs of doctor visits and the tests necessary to make a diagnosis. If you are hospitalized for your condition, Medicare Part A may help cover the costs of your hospital stay and any medication you are given in a hospital in-patient setting. If you are prescribed medications to take at home to treat your condition, Medicare Part D may help.

Part D, or prescription drug coverage, can help lower your out-of-pocket costs for medications you need. If you have Original Medicare, you can enroll in a stand-alone Prescription Drug Plan (PDP). PDPs are offered by private insurance companies, and the costs and benefits can vary. Each PDP has its own formulary, or list of covered drugs. If you have been diagnosed with fibromyalgia in the past year and your current coverage does not meet your needs, consider your options during the Annual Election Period, from October 15 through December 7. Each plan will have tiers of pricing, based on generic, brand-name, and mail order drugs. Search for plans in your area, and compare them to find one that meets your specific needs.

Medicare recipients have the option of getting their benefits through Original Medicare Parts A and B, or through a Medicare Advantage (MA) plan. MA plans are offered by private insurance companies who contract with Medicare. They are required to provide at least the same Part A and Part B coverage as Original Medicare, but many offer additional benefits including prescription drug coverage.  Costs and benefits vary between plans, but online comparison tools can help you make an informed decision.

Related articles:

What is Medicare Parts A & B

What is the Medicare Annual Election Period (AEP)?