Does Medicare Cover an Electrolyte Imbalance?
This article was updated on: 10/06/2018
If your doctor says you have an electrolyte imbalance, it can mean many different things. Electrolytes are electrically charged minerals present in various organs and tissues in the body that have very specific jobs. Depending on what type of electrolyte imbalance you have, you can experience a number of different potentially dangerous symptoms, according to the National Institutes of Health.
What is an electrolyte imbalance?
According to the U.S. National Library of Medicine, common electrolytes include sodium, calcium, potassium, and magnesium, among others. To function properly, your body needs precise levels of these minerals. Electrolytes help:
- Maintain the right amount of water in your body.
- Balance your pH levels.
- Move nutrients and wastes in and out of your cells.
- Keep major organs and tissues such as the heart, nerves, muscles, and brain working smoothly.
When you have an electrolyte imbalance, which generally happens when you become dehydrated perhaps from an illness or disease, you will need treatment to replace lost electrolytes.
What are electrolyte imbalance symptoms?
According to the National Institute of Health, electrolyte imbalance symptoms include:
- Abdominal pain
How is electrolyte imbalance treated?
In a Merck Manual article linked by the National Institutes of Health, replacement of lost fluids and electrolytes is the standard treatment for electrolyte imbalance. In some cases, an oral electrolyte solution may be all that is needed, but in more severe cases, you may need to be admitted for IV fluid and electrolyte replacement.
Your doctor may also treat the underlying cause of electrolyte imbalance, such as diarrhea or vomiting, with prescription medications.
If your electrolyte imbalance causes other dangerous symptoms involving your heart, brain, kidneys, or other organs, you will likely be admitted to the hospital for treatment until your condition stabilizes.
How does Medicare cover treatment for electrolyte imbalance?
Electrolyte imbalances can have potentially life-threatening complications requiring hospital admission. If your doctor admits you for electrolyte imbalance symptoms, your care is generally covered under Part A. You are responsible for paying the deductible for each benefit period, plus a coinsurance amount for each day you are in the hospital. Medically necessary tests and procedures are also generally covered while you are an inpatient. Medicare also covers prescription drugs you receive in the hospital for treatment of electrolyte imbalance.
Out-of-pocket deductible and coinsurance amounts can add up quickly while you are in the hospital and covered under Original Medicare. A Medicare Supplement Plan, or Medigap, covers some or all of your out-of-pocket costs under Part A and/or Part B.
If you have a Medicare Advantage plan from a private insurance company, you have the same benefits, at a minimum, as Original Medicare. However, your out-of-pocket cost-sharing may be lower, depending on the plan you choose.
If your doctor prescribes medications to take at home to treat electrolyte imbalance symptoms, these are generally not covered under Original Medicare (Part A and Part B). However, if you have Part D coverage for prescription drugs, most at-home medications are covered, although you may be responsible for an annual deductible and copayment for each medication you take.
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