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Does Medicare Cover for Atrial Fibrillation (AFib)


Medicare covers necessary services for Atrial Fibrillation. Below we’ll discuss some of the most popular treatments, and how Medicare will cover them. We’ll even go over costs and common questions relating to Medicare and Atrial Fibrillation.

Does Medicare Cover Atrial Fibrillation Treatments

Medicare covers different types of treatments, as long as it’s medically necessary. Should you go to the hospital because of A-Fib, Part A may cover your stay. Doctor’s visits, diagnostic exams, and screenings fall under your Part B.

Just a few treatment options for A-Fib are:

  • Prescriptions that can help your heart rate and rhythm
  • Surgery
  • Lifestyle changes to help promote heart health and reduce risk factors
  • Blood-thinning medications that can help reduce the chances of strokes

Does Medicare Cover Cardioversion

Medicare covers Cardioversion under Part A benefits. Cardioversion is an inpatient therapy that comes in a couple of different forms.

  • Electrical Cardioversion – This is a low voltage shock that helps to regulate your heartbeat.
  • Chemical Cardioversion – You would undergo this treatment in a hospital. You’ll get medications through an IV for this process.

Does Medicare Advantage Cover Atrial Fibrillation

Medicare Advantage plans are great for those looking for an all-in-one plan. Many Advantage policies provide drug coverage. But these policies may not be the perfect match for you. If you buy an Advantage plan, you’ll need to stay within a network in most cases.

If your doctor or hospital isn’t within the network, you can plan on getting some hefty medical bills. Yet, since Advantage plans have to cover all that Medicare covers, this option may work for you.

Do Medicare Supplement Plans Cover Atrial Fibrillation

Medicare Supplement plans can be a lifesaver for those who have high costs. But these plans may not be available for people with A-Fib. Some Medigap companies won’t accept patients who have Atrial Fibrillation. Some companies won’t take those who’ve had A-Fib in the last two years.

But, for many, this condition may not just go away. Because of this, people often wonder if they’ll still be able to buy a Medigap plan with A-Fib. Well, if you buy a policy during your Medigap Open Enrollment Period or during a Guaranteed Issue right, you can avoid answer health questions.

Keep in mind that if you miss enrollment or switch plans, you’ll need to answer those health questions. And, if you need to answer health questions, you may not qualify.

Does Medicare Part D Cover Atrial Fibrillation Medications

Many A-Fib treatments come in the form of inpatient therapy. But others come in the mode of prescriptions. A popular medication to treat A-Fib is an oral drug called Eliquis. If you take this, you’re well aware of how costly it can be.

One month’s worth of Eliquis can cost an average of around $470 a month without insurance. With Part D, you may only pay $10 each month. Most drug plans cover popular medications. In fact, Medicare Advantage plans and Part D drug plans include the majority of drugs that treat A-Fib. Prescription drug coverage proves to be a significant benefit when shopping for the best insurance.

FAQ’s

Does Medicare cover cardiac ablation?
Yes. Ablation has coverage under Part A. This procedure is minimally invasive. It will block the electrical signals that can cause irregular heart rhythms.
Does Medicare cover Cox-Maze, Mini-Maze surgeries, and Hybrid Surgery Ablation?
Inpatient services have coverage under Part A. Cox-Maze is an open-heart surgery that is usually performed along with other heart disease treatments. But, the Mini-Maze is not open-heart surgery. Small incisions are made in the patient’s chest or diaphragm. Hybrid Surgery is where a cardiac electrophysiologist performs a surgical procedure inside the heart, while the surgeon works outside.
Will Medicare cover heart monitors?
Part B benefits will cover heart monitoring. Also, Part B includes cardiac screenings as part of your health visits. But you’ll still pay applicable deductibles and copays. To qualify for a heart monitor, your doctor will need to prove that you’re at high risk.
Will Medicare cover A-Fib catheter ablation?
Catheter ablation is a popular form of treatment among A-Fib patients. Medicare will cover a catheter ablation under your Part A benefits. Catheter ablation can be incredibly expensive, it can end up costing you anywhere from $16,000 – $22,000 for the procedure. Plus, you’ll also have annual upkeep charges that can cost a couple of thousand dollars per year.

How to Get Help with Medicare Coverage for Atrial Fibrillation

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Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

4 thoughts on “Does Medicare Cover for Atrial Fibrillation (AFib)

  1. My husband was in the hospital for 9 days. He had two cardio versions which did not last more than a couple days. He needs ablation but Medicare won’t pay until he is out of hospital for 30 days. Why? They scheduled him for a soon surgery but it was only 27 days after he was released so they had to reschedule him. ???thanks

  2. My Cardiologist recommends (insists) that I get cardiac catheter ablation for the electrical circuitry in my upper heart chambers. I understand the procedure. It would take place as an outpatient procedure at North Shore Hospital In Long Island NY.

    I have limited savings and I need to understand what the actual cost would be for me to have the procedure. I’m 68 and I have Medicare A & B only.

    Can you help me get a handle on what would be My out-of-pocket costs? I see the surgeon on the 29th and he’ll want to get started right away.

    Thanks for your consideration.

    Respectfully,

    Robert Riscica

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