How Does Medicare Cover Essential Tremor?

Posted on January 9, 2019

By Danielle Kunkle Roberts,
Co-Founder of Boomer Benefits

Danielle Kunkle Roberts, Boomer BenefitsEssential Tremor (ET) is a neurological disorder that causes involuntary shaking and trembling. It affects approximately 10 million people in America, according to the International Essential Tremor Foundation, which makes ET the most common neurological disorder.

While not dangerous, the condition can make simple tasks such as tying your shoes or drinking a glass of water more difficult. ET can also get worse over time.

Because ET is more common for people in later adulthood, it’s good to know how Medicare will cover treatment of this disorder.

Medicare Part A Hospital Benefits

Original Medicare is made up of Part A hospital benefits and Part B outpatient benefits. 

Part A covers inpatient hospital stays, skilled nursing facility care, and hospice care. This is the part that would pay most of the expenses related to a hospital stay for deep brain simulation (DBS), which is a common surgery that provides relief from tremors and stiffness.

Medicare Part B Hospital Benefits

Medicare Part B covers outpatient care. This includes doctor visits, preventive care, lab-work, diagnostic testing, emergency care, outpatient surgeries, physical therapy, durable medical equipment and much more.

Part B will pay for your patient visits to your specialist, the necessary neurological exams and lab-work and any outpatient procedures used to control ET symptoms.

One outpatient procedure to treat ET is focused ultrasound treatment. This minimally invasive treatment was approved by the FDA in 2016. It is the first brain disorder treatment to be allowed reimbursement by Medicare Part B. The procedure destroys a small amount of brain tissue that contains nerve cells which are responsible for the tremors.

Earlier this summer Medicare announced benefit coverage for patients in 16 states. Additional states were added this past fall. There are numerous medical centers that now treat patients with Essential Tremor using MR-guided focused ultrasound. A Medicare physician must document why the procedure is reasonable and necessary.

Medicare Part D Drug Benefits

Outpatient medications to help treat your ET symptoms will fall under Part D. Medicare Part D is optional coverage  beneficiaries can purchase to reduce the cost of their prescriptions.

These plans are sold by private insurance companies and each plan has its own premiums, copays, coinsurance, pharmacy network, and drug formulary. Beneficiaries can use Medicare’s Plan Finder Tool to search for the right plan.

Your Medicare Cost-Sharing

As with all insurance coverage, Medicare covers a share and the member also pays a share of their coverage. This is called your cost-sharing and it usually comes in the form of deductibles, copays, and coinsurance.

Part A has a $1364 deductible in 2019, and Part B has a smaller $185 annual deductible. Medicare Part B covers 80% of your outpatient procedures. You are responsible for paying the other 20%.

Fortunately, you can supplement your coverage with either a Medicare supplement policy or a Medicare Advantage plan. Both types of coverage will help to limit your out-of-pocket expenses on the gaps in Medicare.

Beneficiaries can call 1-800-MEDICARE or consult a Medicare insurance broker for guidance in choosing a plan that fits their needs and benefits.

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Danielle K. Roberts is a Medicare insurance expert and co-founder at Boomer Benefits, a licensed agency that helps beneficiaries with their supplemental coverage options.

12 thoughts on “How Does Medicare Cover Essential Tremor?

  1. The treatment for focused ultrasound is still not covered in Florida.
    When will we be able to get treatment?

    1. We don’t have an answer to that. The company that provides focused ultrasound might be your best target. It’s called Insightec. And their website is a good source of information. They call it Neuravive. You can sign up for their newsletter or to get more information.

    1. The food stabilizers/eating tool would not be considered “medically necessary.”

      It would be a “convenience item”

      Medicare does not cover technology or equipment unless it is medically necessary. Though eating tools can greatly improve the convenience of eating, they would not be covered by Medicare.

  2. Why can we not have more then Dr. Alias that does focused Ultrasound at UVA. in Charlottesville. Va. I am on a 2 yr. waiting list and I am having a terrible time with my illiness. Sorry about the spelling, but I feel really bad. See if you can speed it up to get more Dr.s over there that does these ultrasounds.

  3. I found it interesting when you said that because ET is more common for people in later adulthood, it’s good to know how Medicare will cover the treatment of this disorder. My uncle has a shaky hand and he has never treated before. It would be nice to find a solution for his diseases since he lives alone and he can barely eat sometimes.

  4. Has there been any studies on the use of CBD oils?
    I know someone who takes Charlotte’s Web Hemp Oil, don’t know how much a day,
    but seems to help.
    Would like to try it too but it is very expensive and not covered by insurance.

    1. The IETF has not funded a study on CBD oils, but we have a provided a research grant to study the impact of CBD (in pill form) on essential tremor. It’s been a long process to get it under way, but we are hopeful that we will see some definitive information based on the study. Here is a link to the study:

  5. I live in nj ultra sound for ess tremor is covered in ny.
    if I go into ny will my medicare and nj blue cross/blue shield supp pay for

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