How to Select a Pulmonary Rehabilitation Program?

What should I look for in a pulmonary rehabilitation program?

Since most programs are located in hospitals or centers and require outpatient visits several times per week, the location may be a challenge. The PR program may know of ways you can get assistance with travel.

You should look for a program that is specifically designed for people with lung problems. The program should be run by health care professionals who have experience in caring for people with chronic breathing conditions.

The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) has published guidelines that standardize the core components of PR programs, and certifies programs that meet these standards. Many quality PR programs have not sought formal certification from AACVPR. However, be sure to choose a program that has staff trained in management of chronic breathing problems as well as both a supervised exercise reconditioning program and a formal education program.

Do pulmonary rehabilitation programs accept insurance?

Generally, programs accept insurance if you have been given a prescription to attend it, but insurance coverage varies between different rehabilitation programs and between insurance policies. Therefore, the out-of-pocket cost to you (including any co-pays), can vary greatly. Before you enroll in a PR program, ask the staff to help you determine what your out-of-pocket costs will be, including any extras, such as transportation or parking. You may also want to check with your insurance company about the co-pay costs.

Can I enter Pulmonary Rehabilitation if I smoke?

Some programs offer help with quitting smoking as part of the program. Other PR programs require that you stop smoking before beginning the program. PR, medications, and quitting smoking cannot reverse whatever permanent lung damage you may have from cigarettes, but can prevent further damage. If you smoke, make a serious effort to quit. Get help if needed. Stopping smoking is an important part of getting stronger and healthier. Here is more information on quitting smoking.

What happens after I complete the pulmonary rehabilitation program?

The things you learn and practice during the program should carry over into your daily life after the program ends. If you stop exercising after the program, the improvements you made will soon be lost. The staff will work with you to design a long-term plan of physical activity and exercise for you. The staff will teach you how and when to exercise at home. Many programs offer a "maintenance" plan so that you can continue to exercise with others with breathing problems. Once you know how to exercise safely, you have the skills to continue. You might even consider going to a local exercise facility; discuss with your pulmonary rehabilitation team how you can best continue exercising with the facility's equipment. Additionally, many individuals may able to attend an exercise facility free of charge through Medicare plans such as Medicare Advantage or Medigap through the "SilverSneakers" program.

What if I cannot afford pulmonary rehabilitation or a program isn't available in my community?

If you don't have a program in your area, or if there are other reasons why you cannot attend (such as the cost or availability of transportation), there are many things you can do on your own to improve your health and breathing problems:

1. If you are a smoker, seek help from your health care provider to stop smoking.
2. Learn how to correctly use inhaled medicines.
3. Talk to your health care provider about how you can exercise safely in your home community – Stay physically active and exercise regularly!
4. If you have been prescribed oxygen for regular use, be sure to use it with exercise. If you are not sure about using oxygen, talk to your health care provider.
5. Check to see if there are better breathing support groups in your area; these are often free. Some of the resources listed below may help you either find a program or provide you with more information about lung conditions.

Enrollment Process

If you want to live better despite your breathing problems, PR may be a good choice for you. To explore or enroll in a PR program, follow these steps:

1. Find a program
   First, search to find a program near you. If there is a program in your vicinity, contact the program directly to discuss what you need to do to enroll and what your anticipated out-of-pocket costs will be. If you obtain your health care from the Veterans Affairs (VA), you should look into program availability there, which would be covered through your VA benefits. The VA will typically NOT cover an outside program.

2. Seek a referral
   Second, all PR programs will require a referral from your health care provider. Let your health care provider know you would like to participate in PR and partner with them to work through the referral process.

3. Discuss the program details with your health care team
   Before you enroll in a PR program, ask the staff who completes your initial evaluation what your out-of-pocket costs will be, including any extras, such as transportation or parking.

4. Connect with your insurance provider
   Contact your insurance provider to understand your coverage. Coverage varies between different programs and insurance policies. Therefore, out-of-pocket costs and co-pays can vary greatly. Before you enroll in a PR program, ask the staff to help you determine what your out-of-pocket costs will be, including any extras, such as transportation or parking.

5. Self-advocate
   You do not have to wait for your health care provider to bring up PR as a care option. Be an advocate for yourself and ask at your next appointment.

If you would like additional information about pulmonary rehabilitation programs, including specific programs in your area, please visit our PR partner organization’s dedicated PR website, the American Thoracic Society (ATS), at www.livebetter.org and www.thoracic.org/patients

The process outlined in this section is exclusively for people living in the United States. Individuals from outside the United States should check with their local or regional health providers and health authorities about program availability and the referral processes in their area.