If the medical bills run up will my insurance or Medicare cover the cost? Based on what I've been reading, there will be huge medical bills. I myself have COPD and want to know if I could be bankrupt from this lung disease and lose my life savings and my house whereas my relatives receive nothing. And going to a hospice, are there charges during the last stages?

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Larry, you have some very legitimate concerns and are wise to address them now. Have you discussed this with the doctor (presumably a pulmonary doctor) who diagnosed the COPD? If not, I would, as soon as you can.

Doctors often know of programs of which many lay people aren't aware. It was our pulmonary doctor who suggested palliative care; up until that visit I had thought it was an aspect of hospice care, which it's not.

Do you have any medical insurance at all? Are you a Veteran?

As to the huge hospital bills, that depends a lot on the extent of COPD and what remedial actions you can take. Devices such as a flutter valve and incentive spirometer can be used to keep your lungs clearer and strengthen your lung capacity. If you can afford to, get a HEPA air cleaner for the room(s) in which you spend the most time; they help clear contaminants from the air.

If you smoke, quit.

Do you walk, get outside to exercise? Do you take use any inhalers prescribed by a pulmonary doctor? In our area, one hospital has pulmonary therapy. It's a challenge to get it through Medicare b/c the criteria are quite specific, but it's worth a call to your pulmonary doctor to find out if you can participate. Medicare establishes the stringent criteria, but I don't know what criteria might apply for someone who doesn't have Medicare.

Do you sing? Go to church? If so, ask if you can join the choir. Singing expands lung capacity, although it takes years to create the capacity of someone like Pavarotti or Sutherland. I found that I breathed much better when I took voice lessons.

If you can walk outside, start a walking program.

I'm not sure what bearing your relatives and what they receive has on COPD and resulting costs. Could you elaborate?

And remember that you can get Medicare when you're 65.
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1. Unless you are on disability through Social Security Administration, you are not eligible for Medicare until you are 65 or have certain medical conditions (COPD is not one of them).
2. Hospice medical care and equipment and prescriptions are covered by Medicare (see #1 if you are under 65). The living accommodations (nursing home, etc) part of hospice is not covered by Medicare and is usually private pay or Medicaid (the state program that is for low income and low assets individual that cannot privately pay). Some health insurance plans available through work or privately purchased below the age of 65 cover hospice, but not all. There will be charges for various things while you are on hospice, depending on whether you have medicare or some other type of insurance.
3. Yes, you will be expected to pay for your own care with your savings and a lien against your home rather than money go to your relatives. You are not "losing your life savings" - you are spending your money to take care of your own health needs. If you are evaluated as needing a certain level of care, you can write a contract with relatives to provide caregiving services for money from your savings that you pay them and that relatives declare as income as part of your health care expenses. Please be aware of just giving your money or house away - Medicaid will treat any gifts or property transfers within 5 years of applying for help as penalty period and won't pay for a certain amount of time if you go into a nursing home, etc. The sad fact is that unless people are very wealthy, few of us will have an estate to leave to family if we have a catastrophic illness that requires a lot of care, like COPD or dementia or cancer.
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