Atrial fibrillation, also known as AFib, is a serious heart condition that affects an estimated 2.7 million U.S. adults. It causes an irregular heart rhythm and can lead to a stroke or blood clots in the heart.
Medication and treatment can be expensive, but fortunately, Medicare covers both. In this article, you’ll learn about treatment options, costs, coverage, and more.
Does Medicare Cover Atrial Fibrillation Treatments?
Original Medicare covers different treatments for atrial fibrillation, as long as they’re medically necessary.
If a beneficiary needs to stay as an inpatient at a hospital because of AFib, Part A may cover their stay. Doctor visits, diagnostic exams, and screenings fall under; Part B. Treatment for AFib varies and includes different procedures, surgical or nonsurgical.
Treatment options for AFib include:
- Atrial fibrillation ablation surgery
- Prescriptions that help regulate heart rate and rhythm
- Lifestyle changes to help promote heart health
- Blood-thinning medications that can reduce the chances of strokes
Your doctor may request an electrocardiogram (EKG) to evaluate your heart health and check for different conditions. Medicare covers this diagnostic testing, but your out-of-pocket costs depend on where you get the test. You’re responsible for paying coinsurance for Part B, or copayments on a Medicare Advantage plan when you have an appointment with a cardiologist.
Does Medicare Cover Cardioversion?
There are different types of cardioversion:
- Electrical cardioversion – This is a low voltage shock that helps to regulate your heartbeat.
- Chemical cardioversion – Chemical cardioversion is a procedure that uses medications via IV in a hospital to restore the heartbeat.
- Catheter ablation: A doctor uses a flexible thin tube (catheter) through the heart during this procedure. The catheter uses high energy to create small scars, eliminating cardiac tissue that causes the abnormal rhythm.
- Surgical ablation: Surgical ablation, also known as a maze procedure, is performed during open-heart surgery. It involves the removal of tissue that triggers an irregular rhythm.
Does Medicare Advantage Cover Atrial Fibrillation?
Medicare Advantage (Part C) is essentially a bundled plan. It provides benefits for both Part A and Part B.
These plans generally include prescription drug benefits.
With Medicare Advantage, you may have to choose health care providers within your network to get the most coverage from your plan. If you choose to receive care from out-of-network providers, you may have to pay out-of-pocket.
Do Medicare Supplement Plans Cover Atrial Fibrillation?
Medicare Supplement, or Medigap, plans can be a lifesaver for those who have high costs. But, if you have AFib, it’s especially important to know the times when you can get the plan of your choice.
If you were diagnosed with AFib, you can still join a Medigap plan. Yet, you’re only guaranteed enrollment in the plan during your Medicare Supplement Open Enrollment Period or when you have a guaranteed issue right. You may apply outside of these circumstances, but you could face denial due to your pre-existing condition.
Does Medicare Part D Cover Atrial Fibrillation Medications?
As you’ve read above, some AFib treatments come in the form of prescription drugs. An oral drug called Eliquis is a common form of treatment for AFib.
It helps prevent clots in the lungs or in the veins. Without insurance, one month’s supply of Eliquis can cost $499. Fortunately, Medicare Advantage and Part D prescription drug plans include most drugs that treat atrial fibrillation.
How to Get Help with Medicare Coverage for Atrial Fibrillation
Shopping for insurance coverage doesn't have to be hard. Whether you're new to Medicare or want to switch plans, we're here for you. Our team of agents can find the best plan options for you. Simply call the number above or complete an online rate form for your instant quote.