Oct 282011

Are you a senior Medicare recipient who has a breathing problem such as chronic asthma, chronic obstructive pulmonary disease (COPD), emphysema or other respiratory ailment? If you do, you might ask, “Does Medicare cover nebulizers or breathing machines?”

General Medicare Part B Nebulizer Coverage

Medicare Part B will generally cover the rental for a nebulizer, although NOT portable ones, which are considered by Medicare to be a “convenience.” If you need a nebulizer, you will need your primary care physician to write a doctor order for the medical equipment and to present that to a Medicare authorized supplier so that Medicare will pay for the rental cost of the Omron compact nebulizer. Patients will be expected to contribute up to $162 to meet their deductible (for this year, might go up in 2012).

Medicare categorizes these standard rental nebulizers as”capped rental” durable medical equipment. In other words, after the rental period is met, the supplier will transfer ownership to the Medicare recipient. This period is met if a patient uses the equipment for thirteen straight months.

Don’t forget, the supplier must accept Medicare assignment! If they do not, the senior requesting the nebulizer can be charge any cost, with no limit! Don’t let this happen to you or a loved one.

Also, remember that any medication used by the nebulizer will be billed through a Medicare Part D prescription drug plan, which is very different than Medicare Part B. Medicare Part D plans are offered through private healthcare companies to Medicare recipients.

How often should a nebulizer be replaced?

A good rule of thumb is that a nebulizer should be replaced after 5 years. This is assuming that it is still working at that time, of course.   Patients and caregivers can increase the life of a nebulizer by carefully following the maintenance schedule for the nebulizer that is provided by the manufacturer.

Which nebulizer machine compressor is the best?

This depends somewhat on the patient’s individual case. There are many manufacturers of nebulizer compressor machines. Here are a few popular makes and models of nebulizers.

Respironics Inspiration Elite Compressor Nebulizer (Philips)

Compmist Compressor Nebulizer

Respironics Optionhome Compressor Nebulizer (Philips)

Beurer Nebulizer Compressor Machines

Pari Vios Nebulizer Compressor

Omron Compair Elite Nebulizer Compressor

What types of nebulizer masks or mouthpieces are best for me?

Usually, the choice between a nebulizer mask or mouthpiece is largely dependent on the patient’s preference. Obviously, for patients that have difficulty holding a nebulizer mouthpiece, a mask will be best. Other patients may find it uncomfortable or distressing to have a mask attached to their face. In that case, a mouthpiece may be better. If using a mask, it should fit well and cover both the nose and mouth.

How should I clean my Omron nebulizer, mask, mouthpiece and tubing? What is the proper maintenance schedule?

Follow the instructions from the manufacturer. Generally, these must be cleaned regularly to prevent mold or bacteria from growing on moisture that will collect in the equipment.

First, detach the tubing and let it hang. This will allow ambient moisture to evaporate from the tubing and port areas. Then run the compressor so that it dries the inside of the nebulizer .  After each use, the nebulizer should be rinsed with warm water to remove any medication still inside(remember that the nebulizer itself is the plastic piece that has the medication — not the compressor) .  It may be washed with warm water and dish soap, then rinsed well and allowed to dry thoroughly.  Do not wash the tubing or mask.

The nebulizer may also be washed in the top rack of your dishwasher.  Do not run warm water or clean the inside of the tubing or mask.  Patients can wipe the exterior of the tubing occasionally with warm water.  The nebulizer may be occasionally disinfected by boiling in water for 10 minutes. Again, do not boil the tubing or mask.

What medications can I use in my nebulizer?

There are a variety of inhaled medications that may be used in a nebulizer. The most common is albuterol solution for inhalation. Albuterol is a bronchodilator that will make it easier for someone to breath when they are suffering from acute symptoms from asthma, COPD, emphysema or other chronic respiratory conditions.  For this reason it is often referred to as a “rescue” medication.  Most of the albuterol solutions used now are premixed — however, there may still be those that remember (or even use) the concentrated solution that must be manually mixed with sodium chloride for inhalation solution.  These older formulations are more difficult to use and may lead to toxicities if used improperly. For this reason, the premixed ampules are much more popular, as their is no concern about mixing properly. The solution comes in a few different doses. By far the most common is the 0.083% albuterol premixed ampules 3ml size.

For those suffering from COPD, a common combination is premixed albuterol and ipratropium bromide.  Ipratropium is a longer-acting beta-agonist — it helps to keep the airway more open over longer periods of time. By itself it is not considered a “rescue” medication.   Patients may recognize it as the branded version of the inhaler Combivent.

Other common medications that may be used in a nebulizer include Formeterol or Budesonide.

What if my nebulizer isn’t enough to help my breathing? What if I need oxygen? 

Many seniors may find that they need supplementary oxygen in addition to a nebulizer. Check our post about how to get help from an oxygen concentrator medical supply order.

Here is an informational video that demonstrates how to use a nebulizer compressor :