Insomnia is a sleep disorder that can affect anyone, but seniors often experience changes in sleep patterns, finding it more difficult to fall – or stay – asleep. Occasional disturbances in your sleep can be natural, but when it becomes a chronic condition, it can help to talk to your physician. With a medical exam to rule out underlying conditions, some lifestyle changes, and if necessary, medication, you can prevent insomnia and get the sleep you need to stay healthy and active.

Managing insomnia can be a challenge if an underlying medical condition is affecting your ability to get a good night’s rest. Heart and lung conditions, gastroesophageal reflux disease (GERD), urinary problems, Alzheimer’s Disease, and Parkinson’s can cause sleep issues in seniors. Sleep apnea, restless leg syndrome, or rapid eye movement sleep disorder can contribute to your insomnia, and mental health issues, including depression, anxiety, and stress, can lead to poor sleep quality.

If you have been noticing changes in your sleep patterns, talk to your doctor. Aside from more serious underlying illnesses that can be diagnosed and treated, chronic insomnia can lead to slower reflexes, a lack of energy, and an increased risk of high blood pressure and heart disease. Your physician will review your current health and sleep habits, and may suggest changes in lifestyle that may include more physical activity, and less caffeine and alcohol. Your doctor may recommend a sleep study, which involves tests and monitoring to determine the best way to treat your particular sleep disorder.

Cognitive behavioral therapies, including relaxation techniques and sleep restriction, can improve your sleep, but if your insomnia continues, your physician may prescribe sleeping pills. There is a wide variety of sleeping pills that may be prescribed by your doctor, including Zolpidem (Ambien), Eszopiclone (Lunesta), or Zaleplon (Sonata).

Can Medicare Help Cover Treatment for Insomnia?

Medicare Part B (Medical Insurance) will help cover the costs of medically necessary care and services, including your visit to the doctor to address your insomnia. While Medicare Part B is optional for individuals with Original Medicare, most recipients enroll when they are first eligible to avoid paying a late enrollment penalty later on. You will likely pay 20% of the Medicare-approved amount of your visit, and the Part B deductible will apply.

If your physician prescribes medication to help treat your insomnia, you will need to be enrolled in Medicare Part D drug coverage. If you have Original Medicare, you can enroll in a stand-alone Prescription Drug Plan (PDP). Many people on Medicare choose to get their Part A and Part B benefits through a Medicare Advantage (MA) plan. MA plans are required to provide at least the same coverage as Original Medicare, but many offer more, including prescription drug coverage.

Prescription Drug Plans and Medicare Advantage plans with prescription drug coverage have their own formularies, or list of covered drugs. Each plan will also have its own levels of pricing, usually based on whether your medication is brand-name, generic, or purchased through mail-order. If you are already enrolled in prescription drug coverage, check with your plan to find out your exact cost for the sleeping pills your doctor prescribes for you.

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