According to the American Heart Association, nearly half of all Americans aged 20 and up are affected by cardiovascular disease. Most cases of cardiovascular disease are caused by hypertension, however, coronary heart disease and heart failure also play a significant role.
Medicare pays for various cardiac diagnostics and treatments, including scans, rehabilitation, and psychotherapy.
Does Medicare Cover Preventing and Treating Heart Disease?
Costs associated with cardiology-related services, including screenings, diagnosis, and treatment, are partially or fully covered by Original Medicare (Parts A and B). Medicare assists in covering the following:
- Heart Disease Screening
- Psychological and Behavioral Counseling and Therapy
- Rehabilitative Cardiology (a workout regime for those with heart illness)
- Certain medicines
- Appointments with the doctor
- Open-heart surgery
What Is Included in Different Sections of Medicare
Every Medicare part contains various expenses related to cardiovascular illnesses.
It provides hospital insurance, and after the deductible is reached, it will pay 100% of your hospital bills for up to 60 days. If your hospital stay is over 60 days, you will be responsible for paying your deductible and any applicable coinsurance. Accommodation in a semi-private room, hospital meals, and prescription medication are all paid for.
Medicare Part B
Medicare Part B insurance pays for 80% of out-of-hospital treatment (such as doctor visits and lab work). After your deductible has been met, you will typically be responsible for 20% of the remaining expenditures. The following are components of coverage:
- Appointments with your family doctor
- Cardiology checkups
- Rehab services for cardiac patients
- Diagnostic procedures like electrocardiograms (EKGs), MRIs, CT scanning, and stress testing
- Screening for Heart Disease
Medicare Part C
Commercial insurance companies offer Medicare Part C “Medicare Advantage” plans under contract with Medicare. The law mandates that the plans cover the same services as Original Medicare (Parts A and B). Medicare Advantage plans may partially cover certain prescription drugs for cardiovascular disease (CVD) treatment.
Your out-of-pocket expenses will change based on your specific plan and location. Also, it could cost you more if you visit a specialist or get treatment at a hospital not part of your Medicare Advantage plan’s network.
Medicare Advantage plans are a popular choice for seniors who want additional benefits and coverage.
Private insurance firms offer Medicare Part D or the Prescription Drug Plan. Medication to treat cardiovascular disease (CVD) is expensive, but these plans can help cover the cost. You should review the plan’s formulary to see if the medications your doctor has recommended are included in your plan’s coverage.
Medigap plans, often known as Medicare Supplement plans, are supplementary insurance coverage private companies offer to augment Original Medicare. Depending on the specifics of your insurance, these plans may help cover some of your Medicare Part A and Part B deductibles and copayments.
Medicare Coverage for Heart Disease Tests and Therapies
There are two kinds of cardiovascular disease screenings, and Original Medicare will pay for each. It also offers complete reimbursement for all expenses related to preventative behavioral therapy for cardiovascular disease.
A blood test for cardiovascular disease is one form of screening covered by Original Medicare. This test looks for signs of disorders that could lead to a heart attack or stroke. Medicare will pay for an ultrasound to detect the disease if you have a high risk for abdominal aortic aneurysm, in which the main artery supplying blood to your legs expands and bulges.
Medicare Coverage for Heart Disease Screenings
Screening for Cardiovascular Disorders
Once every five years, Medicare Part B will pay for a person’s total cost of a blood test for cardiovascular disease. The following parameters are evaluated during the examination:
- Cholesterol, a fatty acid produced in the liver, produces hormones, vitamin D, and other compounds that aid digestion
- The fatty acids known as lipids include vegetable oils, waxes, and even steroids
- Triglycerides are a form of fat that the body stores for energy
Screening for abdominal aortic tumors
Medicare Part B will pay for an abdominal aortic aneurysm screening ultrasound if you are at risk. You can participate in the screening if aortic aneurysms in the abdomen run in your family. Or if you are a male between the ages of 65 and 75 and have smoked 100 cigarettes throughout your lifetime.
If your doctor thinks you’re at risk for developing an abdominal aortic aneurysm and then refers you for the test, Medicare will pay 100% of the cost.
Medicare Cover of Cardiovascular Behavioral Therapy
Medicare will cover the cost of one annual cardiovascular cognitive therapy session. This discussion often occurs during a scheduled appointment with your primary care physician or another appropriate healthcare provider.
The goal of the appointment is to expand your knowledge of the risk factors for CVD and provide you with tools to help you modify your behavior to lower that risk. Cardiovascular Behavioral Therapy includes:
- Examining your pulse and blood pressure
- Risk reduction strategies, such as the usage of aspirin, are discussed (if suitable for your illness)
- Guidance on how to eat well and reduce your risk of disease
Discuss your situation with your doctor and the costs associated with your care, including the price of any drugs. Also, remember that Medicare doesn’t pay for everything. Alternatively, you can obtain additional insurance from private firms, which may help reduce out-of-pocket expenses.