Vertigo is a common medical complaint in those who are over the age of 50. It’s a complex problem that may be caused by a number of different disorders. In many cases, no cause for vertigo is found.
In order to investigate why a patient is suffering from vertigo attacks, doctors will often perform a number of tests to determine what the cause is and the best course of treatment.
Seniors who are on Medicare need to know what tests and treatments that their Medicare insurance will take care of, and whether or not any drugs prescribed for the condition will be covered under Medicare Part D.
What is Vertigo?
Vertigo has a number of causes. In general, vertigo is a sensation of extreme dizziness and/or a sensation that one is spinning or that the room itself is spinning.
The main disorder that causes vertigo is referred to as benign paroxysmal positional vertigo(BPPV). In BPPV, an attack of vertigo is brought on by movements of the head.
Vertigo may also be caused by an infection in the inner ear. When a person has an upper respiratory infection, labryinthitis may develop in the ear leading to dizziness.
Vestibular neuronitis also causes vertigo. This condition causes inflammation of nerves in the ear leading to dizziness.
A more serious condition that has vertigo as a symptom is Meniere’s disease. This is a complex condition that requires long-term treatment.
In order to determine the exact cause of a patient’s vertigo, doctors will perform tests to rule out certain conditions. Most physicians will do basic blood tests to check for an electrolyte imbalance that may be a cause of any dizziness.
Some doctors will perform tests to check for involuntary eye movements when the patient’s head is placed in several different positions. These tests are known as electronystagmograpy (ENG) and videonystagmography (VNG). Some doctors will also recommend an MRI.
Does Medicare Pay For Testing?
The important question is who will be responsible for paying for doctors’ visits and medical services? Medicare Part B pays for doctors’ visits to primary care physicians and specialists as long as the visits are medically necessary.
Medicare Part B will also cover diagnostic tests. If the doctor recommends blood work and diagnostic tests such as the ENG and/or the VNG, these will usually be covered by Medicare. MRI scans will be covered if the doctor determines that they are medically necessary to diagnose the condition.
We now know what some of the causes of vertigo are and how they are diagnosed. Treating vertigo is based on knowing the cause, if there is one.
For those with vertigo due to an infection of the inner ear, the doctor will normally prescribe an antibiotic to be taken for ten days. This treatment should clear up the vertigo symptoms once the infection is cleared.
For those with vestibular neuronitis, there aren’t any really good treatments. Doctors usually recommend bed rest until the symptoms improve. They usually do in a couple of weeks.
Patients that have BPPV have several treatment options. One of the oldest options is to control the vertigo by taking an antihistamine pill with the active ingredient of meclizine. This medication is now available over-the-counter. Some doctors will recommend newer antihistamines that will require a prescription.
Canalith repositioning is often used to treat BPPV. This treatment seeks to reposition particles in the ear canal that may be causing vertigo back to a position where they aren’t causing symptoms.
The head is placed in four different positions. Each position is maintained for about 30 seconds. The doctor will show the patient how this treatment is done, and then the patient can do it at home.
In some very severe cases of vertigo, the doctor may recommend a surgical procedure called canal plugging. This is only used if all other treatments are ineffective.
What Treatments Does Medicare Pay For?
Medicare Part D coverage will pay for antibiotics to treat vertigo. It will also pay for prescription antihistamines. It will not pay for over-the-counter drugs like meclizine.
As far as surgical treatment goes, Medicare and Medigap Plans will normally only pay for a surgical treatment if non-surgical options have not been of sufficient benefit. A patient’s doctor would need to contact Medicare and consult about surgical need.
As we’ve seen, vertigo is a complex problem with multiple treatments. However, there are treatments and tests available. Most are covered for seniors by Medicare.