Does Bronchiectasis warrant a COPD diagnosis

I am not (yet) on Medicare but have wondered how it works with pre-existing conditions, since by 65 many have one. BE is a form of obstructive lung disease, as is COPD, so it would be curious to me if they were treated differently with regard to policy’s underwriting. With that said, I am surprised that you cannot change your supplemental policy with a COPD diagnosis since I had many with COPD in my pulmonary rehab program and it was around the yearly Medicare renewal period so everyone was being encouraged to make sure their policy still covered meds, etc. Perhaps it is something specific to the supplemental policy. Perhaps obvious, but many here are in Medicare with supplemental plans so hopefully others will have direct experience and something actually helpful to share.

Like @bayarea58 I have not heard of being denied coverage based on pre-existing conditions.

I believe COPD is often a diagnosis of exclusion, and with MAC and bronchiectasis there are a lot of shared symptoms. Low spirometry readings often result in COPD type diagnoses. If you have COPD it might not be possible to remove it from your records. I guess I would want to understand how the COPD diagnosis was made. Is it possible to get a copy of your recent medical records (or read the reports on the portal) to see how and when it was made?

Changes to such medical plans are only possible once a year during open enrollment. If you are trying to change outside of this period, that might be the reason you've been denied.

I HAD A DIAGNOSIS OF COPD IN ADDITION TO ASTHMA AND BRONCHIECTASIS FOR YEARS ON MY RECORDS. MY NEW PULMONOLOGIST REMOVED COPD FROM MY HEALTH RECORDS. HE SAYS, WHILE TREATED THE SAME THEY ARE NOT THE SAME DIAGNOSIS. PERSONALLY, I DON'T UNDERSTAND BUT THAT WAS WHAT HE SAID.

Thanks for the input. I’ll see my pulmonologist soon for results of my CT scan. The CT should show if I have COPD in addition to the others. By the way, the Medicare supplements initially have to take you with preexisting conditions, but if you later want to change to a lower cost policy, they can deny. The Part D drug plans are the only ones restricted to the enrollment period so the Part B supplements can be changed anytime if you qualify. I will find out if Bronchiectasis is viewed in the same way as COPD by the insurance companies.

BE is widening of the bronchii , so anti-obstructive
Although
- when they are full of mucus -
-or why are they widened - is it a reaction to obstruction ?

there are clear guidelines for COPD-definition,
changed recently

GOLD 2024 defined COPD as a heterogeneous lung condition characterized
by chronic respiratory symptoms (dyspnea or shortness of breath, cough,
sputum production or exacerbations) due to abnormalities of the airways
(bronchitis, bronchiolitis) or alveoli (emphysema) that cause persistent,
often progressive, airflow obstruction.[9]
https://goldcopd.org/2024-gold-report/

I have none of the typical attributes of COPD , it's just post-pneumonia.
Still, when they just go by FEV1 in the new definition , I do have COPD.

And this apparently now also includes many cases of severe longterm COVID,
with no COPD-signs before infection.

I believe there are a couple of tests to differentiate COPD from BE. Spirometry might be the first test and if the results indicate a reduced ability to fully exhale, then a CT scan might be ordered. Overinflated lungs due to narrowing air passages would indicate obstruction and perhaps a COPD diagnosis.

It’s not unusual to have both BE and COPD.

Hello bayarea58,
You are right about needing to know the underwriting policy.
At approaching 65 there is much research and a lot to understand.
The Supplement Plans, A - G , are easy to comprehend, grasp and understand.
The Advantage Plans can be as different as night and day from one insurance carrier to another, as different as the Insurance Carrier itself.
If you choose Original Medicare with a Supplement Plan and Plan D, drug plan, they all work together.
If you choose an Advantage Plan you know longer have Original Medicare you have a typical insurance carrier plan and the insurance carrier more or less calls the shots and there are big differences, usually in how much they pay for certain medical needs compared to the Original Medicare with a Supplement and D Plan and as well another difference is where you can go for medical care etc. especially how it works if traveling in the US or overseas.
Once you choose a Supplement Plan to go with Original Medicare and you want to change to another carrier's Supplemental Plan down the line you must go through underwriting which you do not have to do at age 65, all pre-existing health problems are covered if you sign up for either , the Supplement or the Advantage, at age 65. However if after you have a Supplemental Plan and you want to change and have developed a medical problem, after having signed up at age 65, that they consider 'a risk', they have the right to turn you down, meaning the insurance company you were trying to change to.
With the Advantage Plan it is all inclusive, medical and drugs. You can switch once a year during open enrollment to another Advantage Plan, another insurance carrier. No underwriting from what I understand.
With the Supplement Plan you can choose , once a year, another Plan D, the drug plan, if you want and need to. Again, with the Supplement Plan, the medical part, and wanting to change carriers, it will have to go through underwriting and you can be turned down.
With the Supplement Plan it is typically, a larger amount for the monthly premium vs the Advantage Plan monthly amount, the premium. However with the Supplement Plan it is a very small deductible annually, the Original Medicare Deductible amount. The Advantage Plan is usually a large annual deductible with co-pays etc. They tout bells and whistles, but one must truly understand all.
So if you eventually become one who has to go to the hospital due to ones health or an unexpected injury, you pay the 'large' deductible yourself every year with the Advantage Plan vs. a small deductible with the Supplement Plan. There are other differences also, especially if you need more than 20 day in a rehab facility. Supplement Plans give you many more days and most people need more than 20 days to get it right and complete.
I hope that this somewhat answers what you were wondering about and hope I explained it where it makes sense. By the time you sign up it could have all changed...or it just might change this year ( I doubt that, however) with all the changes being talked about politically.
Barbara

@bsi15 I see your logic but having widened, scarred, dysfunctional airways is not anti-obstructive. BE falls under the umbrella of obstructive lung disease as it can (depending on severity) impact our ability to fully exhale, leading to air trapping. A quick google search will confirm what I am explaining and I am sure your pulmonologist can further explain it to you better than I.

@bsi15 is your treating doctor a BE specialist? FEV1 is also impacted by BE. If your FEV1 is low that shows you have some form of obstructive lung disease, it does not by itself mean you have COPD. Too many doctors use “COPD” as short hand for any/all obstructive lung disease which is simply not accurate. Asthma can also be obstructive (asthma can also be restrictive, or both obstructive and restrictive underscoring the complexity of asthma). It seems like you need to sit down with your doctor and really suss out what is going on and why you have a COPD diagnosis in your chart.