Q Does Medicare have coverage for these special treatments I’m reading about for people having “long COVID-19” or “long-hauler” symptoms?
A The Centers for Disease Control and Prevention (CDC) have identified post COVID conditions (PCC) as a wide range of new, returning or ongoing health problems that people experience after being infected with the virus that causes COVID-19.
Long COVID, long-haul COVID, post-acute COVID and chronic COVID-19 are all terms now being used to refer to PCC. It’s estimated that 1-in-5 adults who survive COVID develop long COVID. The number increases to 1-in-4 for those 65 and older.
There is a higher risk for people who were severely ill from COVID, but even people who had a mild case, or were asymptomatic, can develop PCC.
Older adults are at a greater risk for kidney failure, respiratory and pulmonary complications, neurological conditions and mental health conditions.
Some of the common symptoms of PCC are: fatigue, chronic cough, chest pain, post-exertional malaise (both mental and physical), respiratory distress and shortness of breath, fast or irregular heart rate, inflammation of the heart, “brain fog” such as inability to concentrate or memory loss, headaches, joint or muscle pain, depression, anxiety and renal disorders.
Symptoms vary and often mimic and include other complex conditions. Older adults, and those facing underlying health inequities, may face more challenges getting properly diagnosed and treated.
According to The National Center on Law and Elder Rights there is a new diagnosis code, ICD-10, for “Post COVID-19 Condition, Unspecified” and the Center for Medicare and Medicaid Services has expanded Medicare coverage for pulmonary rehabilitation services due to long COVID.
Additionally, state Medicaid programs must cover treatments for COVID-19, as well as treatments and therapies for long COVID.
Those with long COVID generally benefit from health care services that include multidisciplinary
teams from a range of specialties to address the issues of COVID-19 recovery. Long-COVID or post-COVID care centers are available in some states, and 18 clinics have been established at Veterans Administration facilities, too.
Q I’m 59 and was planning on working until I was 67, but I got COVID-19 last year and still haven’t recovered. Can I get Social Security Disability Insurance?
A In 2021, the Department of Health & Human Services Office for Civil Rights and the Department of Justice issued a guidance that long COVID can be a disability under the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act of 1973, and Section 1557 of the Affordable Care Act. Each of these federal laws protects people with disabilities from discrimination.
Long COVID may present a vague set of symptoms, not unlike other conditions, such as fibromyalgia or chronic fatigue, that have also been approved for Social Security Disability Insurance (SSDI) benefits. However, these types of conditions are more difficult to prove because they generally cannot be diagnosed with one medical test.
Applying for SSDI can be a lengthy process that requires a great amount of documentation. Initial applications filed with the Social Security Administration can take three to five months to get a decision. If that initial application is denied, it can take four to six months for the application to be reconsidered on a first appeal.
While some people have been awarded SSDI due to COVID-19-related symptoms, most were experiencing complications from having been on a ventilator for an extended time and were not categorized as COVID long-haulers. The reason for this is Social Security disability is designed for people who suffer mental or physical conditions that have lasted, or are expected to last, at least 12 months, and many of those who have long COVID symptoms haven’t met the time requirement yet. The National Center on Law and Elder Rights and advocates from Justice in Aging believe the number of long COVID claimants will increase and that there will have to be more response from the federal government to address the needs of those who are unable to work anymore.
The advice being given is to work with your doctor, document your symptoms and how it is impacting your daily life and ability to work, and apply earlier rather than later as the process might be very lengthy.
For more information about applying for SSDI, visit www.ssa.gov/benefits/ disability or call your local Social Security Administration office.
Sara Duris is community information liaison of Region IV Area Agency on Aging in Southwest Michigan. Questions on age or independence services? Call the Info-Line for Aging & Disability at 800-654-2810 or visit areaagency onaging.org. The Generations column appears each weekend in The Herald-Palladium.