Understanding Medicare Benefits for Cerebral Palsy Treatment

A comprehensive Medicare plan can help cover Cerebral Palsy. Call (800) 960-0608 today to connect with a licensed insurance agent to learn more about Medicare plans in your area.

Are You Living With Cerebral Palsy?

While it’s considered rare, with only 200,000 Cerebral Palsy cases diagnosed in the United States per year, millions in the United States are currently living with Cerebral Palsy according to the American Medical Association. The neurological disorder isn’t life-threatening, but it can cause numerous complications that affect everyday life. It can be especially debilitating for older adults living with Cerebral Palsy.

To combat the symptoms of Cerebral Palsy, regular treatment, such as physical therapy, occupational therapy, speech therapy, CPT, and other assistive medical services are a necessity. If you’re a senior living with Cerebral Palsy, you may be wondering if Medicare, Supplemental Security Income (SSI), or Social Security Disability Insurance (SSDI) offers health care coverage for Cerebral Palsy services and treatment. After all, it offers coverage for numerous neurological conditions, but it may not offer full coverage for all of them. 

Understanding Cerebral Palsy: What is Cerebral Palsy?

Cerebral Palsy isn’t a typical single condition. The neurological disorder is actually a cluster of disorders and disabilities that affect the motor cortex. Cerebral Palsy is classified as a “non-progressive” disorder, which means that it doesn’t get worse, but its symptoms can cause numerous issues for adults living with the disorder. This especially includes senior citizens living with Cerebral Palsy. 

Because of how it can present, Cerebral Palsy is often viewed as an intellectual disability. While it can run comorbid with intellectual disabilities, Cerebral Palsy itself is not an intellectual disability. The cluster disorder attacks muscle tone, movement, balance, and coordination, which often leads to the following issues:

• Delayed developmental milestones (athetoid cerebral palsy)
• Weakness in arms or legs (often leading to physical abnormality such as scoliosis or decreased muscle tone)
• Movements that are spastic, clumsy, jerky, or fidgety
• Uncontrolled movements and uncontrolled muscle contracture (common with spastic diplegia cerebral palsy)
• Tremors (spastic shaking movements)
• Hypotonia (appearing to be too stiff or floppy)
• Speaking and communication difficulties (often mistaken for symptoms of brain damage)
• Problems with sleeping and sleep pattern abnormality

Given the typical image of someone with Cerebral Palsy, it’s assumed that individuals living with the disorder are suffering from some form of brain damage and require round-the-clock care for life. This isn’t always the case. Individuals with mild or even moderate forms of the disorder can lead relatively normal everyday lives (especially with treatment form medications like baclofen, and regular physical therapy and occupational therapy). However, this doesn’t mean that they aren’t in need of treatment for symptoms, which they aren’t always getting for a variety of reasons.

Does Medicare Cover Cerebral Palsy? Cerebral Palsy Treatment Coverage Under Medicare

Cerebral Palsy in older adults, even mild forms, can be very debilitating. As you age, your mobility and balance naturally begin to decline. Cerebral Palsy in older adults can make typical mobility and balance issues even more difficult to live with. To lessen the issues that come with Cerebral Palsy in seniors, extensive treatment is needed.

The good news is that Medicare coverage is available for much of the treatment needed for Cerebral Palsy in older adults. It can even cover some of the special supplies that help seniors with the condition maintain mobility and balance. For instance, Original Medicare covers orthopedics and orthopedic shoes. However, that Medicare coverage comes with conditions: in order to have orthopedics covered by Original Medicare, you must first meet the $233 deductible.

If you find that Original Medicare doesn’t cover the treatment you need for Cerebral Palsy, a private insurance company that offers a Medicare Advantage plan may have what you need. Medicare Advantage plans (offered by a private insurance company) cover the same treatments and services that Original Medicare covers, but they can also offer health care coverage that Medicare Parts A and B do not. 

If you need coverage for Cerebral Palsy services and treatment that isn’t available through Original Medicare or Medicare Advantage, don’t lose hope. Medigap plans and Medicare Part D Prescription Drug coverage may be able to help you fill in the gaps, so to speak, left by other Medicare coverage.

How Can I Find Medicare Coverage for Cerebral Palsy In My Area?

Treatment coverage for Cerebral Palsy  through Medicare Advantage plans can vary from location to location. For this reason, it’s important to thoroughly research and compare the Medicare health insurance plans available in your area. To get started, feel free to enter your zip code into our free plan finder! This important tool can help you locate Medicare plans near you that offer the coverage you need.

When you’re ready to further discuss plan options near you, our friendly licensed agents are standing by. To reach them, all it takes is a quick call to (800) 950-0608! They’ll be happy to answer any questions you may have regarding Medicare plan options near you.