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Finding a Medicare Cardiologist


Medicare covers medically necessary inpatient and outpatient services provided by a cardiologist. Medicare coverage to prevent and treat cardiovascular disease is also available. Depending on the service, Medicare Part A or Part B will provide your benefits. Medicare Part A covers hospitalization for a heart attack, stroke, heart surgery as well as rehabilitation. Part B covers doctors’ appointments and required medical equipment. Your exact coverage will depend on your condition and the type of plan you have.

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Below we review Medicare coverage for cardiologists and cardiovascular disease.

Does Medicare Cover Cardiologist Visits?

Medicare typically covers cardiologist visits if the service is deemed medically necessary and is provided by a Medicare-accepting physician.

Medicare Part B, which covers medical services and outpatient care, will cover cardiologist visits for diagnosis, treatment, and management of heart-related conditions. Medicare also covers certain cardiac tests, such as electrocardiograms (ECGs), stress tests, and echocardiograms.

However, it is important to note that Medicare coverage may vary depending on your specific plan and the specific services you receive from your cardiologist. It is always a good idea to check with Medicare or your healthcare provider to determine the exact coverage and costs associated with any medical service or treatment.

Does Medicare Cover Outpatient Heart Procedures?

Medicare Part B will cover preventative and outpatient heart procedures you might need. Medicare will cover preventive services at 100%. However, you’ll likely be responsible for coinsurance for outpatient services. On average, outpatient procedures are typically less expensive and less invasive than inpatient procedures, and they allow patients to return home on the same day.

Preventative services may include:

  • Aneurysm Screens
  • Cholesterol Screens
  • Blood Pressure Screens

Outpatient services may include:

While preventive services have full coverage, diagnostic procedures, and treatments require you to pay a portion of the bill. A Medigap plan can reduce the amount you must pay for procedures.

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How Much Does Open Heart Surgery Cost With Medicare?

The cost of open-heart surgery with Medicare can vary depending on a number of factors such as the type of surgery, the hospital or medical facility where the surgery is performed, and any additional medical treatments or services needed.

Medicare typically covers a portion of the cost of open-heart surgery, but the exact amount of coverage will depend on the specific Medicare plan and the individual’s circumstances. Usually, Medicare Part B will cover 20% of your costs if the procedure is preformed in an out-patient setting. However, open heart surgery is rarely outpatient. Thus, Medicare Part A will cover most of the costs.

It’s recommended that you speak with your healthcare provider and your Medicare plan provider to get a more accurate estimate of what your out-of-pocket costs might be for open-heart surgery.

Does Medicare Cover Heart Stents?

Carotid artery stenting is not covered by Medicare without embolic protection. Further, Medicare will only cover carotid artery stenting in facilities that meet CMS’s minimum standards. Also, coverage is only available when using FDA-approved carotid artery stents and FDA-approved embolic protection devices.

Does Medicare Advantage Cover Cardiovascular Disease?

Medicare Advantage plans must provide benefits that at least match Original Medicare. Thus, you will receive coverage for cardiovascular disease. Yet, restrictions like doctor networks and high out-of-pocket costs may accompany this type of coverage.

Each Medicare Advantage company and plan is different depending on your location. Plus, the plans change each year during the Annual Enrollment Period. So, you’ll constantly need to ensure you are enrolled in the best coverage for you.

What Are the Costs with Cardiovascular Disease if I Have a Medicare Advantage Plan?

Let’s say you have an Advantage Plan with a $35 monthly premium and a $6,000 Maximum Out-of-Pocket. Your focus may be on the affordable premium. But emergency medical bills may bring you an unpleasant surprise.

Once you spend $6,000 out-of-pocket on medical services, the plan approves, then they’ll cover your medical bills in full. Remember, the maximum out-of-pocket resets every year on January 1st.

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Do Medicare Supplements Cover Cardiovascular Disease?

Medicare Supplement plans can reduce your costs. Doctors’ appointments, hospital stays, surgeries, and medications are costly, even after Medicare pays its portion. A Medigap plan will cover all your out-of-pocket costs on anything Medicare covers.

What Are the Costs with Cardiovascular Disease if I Have a Medicare Supplement Plan?

So, let’s say you have Medigap Plan G, which is super easy to understand. With this plan, you’ll pay the premium and the Part B deductible.

An ambulance falls under Part B benefits, so if you didn’t meet the deductible, you’d pay it here. Then, when you go to the hospital, the plan will pay all your coinsurances and Part A deductible.

The difference between Medigap and Medicare Advantage is significant savings. As long as you keep paying your monthly premium, you can count on Medigap to be there for you when you need it.

Does Medicare Cover Prescription Drugs for Cardiovascular Disease?

Most people with cardiovascular disease  need medications. Part A and B don’t cover prescription maintenance drugs, but Part D will. You can opt into buying a stand-alone drug plan or even get a Medicare Advantage Part D policy.

What Cardiac Medications Does Medicare Cover?

Medicare covers the following cardiac medications.

  • Anticoagulants
  • ACE Inhibitors
  • Beta-Blockers
  • Cholesterol-Lowering Medications
  • Diuretics

Monthly premiums generally depend on where you live. But most stand-alone drug plans cost around $33 a month.

Further, the average monthly price of cardiovascular medications is about $100 a month. But, Part D can help you lower medication costs.

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Does Medicare Cover Heart Monitoring and Testing?

Medicare will cover critical testing. Part B will cover a Cardiovascular blood screen test every five years. The blood screen will include cholesterol, lipids, and triglyceride levels.

If your doctor accepts Medicare, you won’t pay for this screen. Sometimes, your doctor wants more screens than Medicare will cover. When Medicare doesn’t cover a test, you’ll pay the bill.

Does Medicare Cover Cholesterol Tests?

Part B will cover blood tests for heart disease once every five years. The blood test will look at your cholesterol, triglyceride, and lipid levels to detect conditions that could lead to heart disease. You won’t pay anything for the test if the doctor accepts Medicare assignment.

FAQs

Does Medicare cover cardiovascular behavior therapy?
Yes, Medicare covers a yearly cardiovascular behavioral therapy visit.
Does Medicare cover open heart surgery?
Yes, Medicare covers open heart surgery, which is necessary.
Does Medicare cover cardiac rehabilitation?
Medicare covers cardiac rehab if your doctor finds it necessary.  Rehab services can help reduce risks and improve health. Part B covers two types of cardiac rehab – general and intensive. Also, Part B covers general rehab sessions for 1-2 hours per day.

You’ll have coverage for 36 sessions within a 36-week timeframe. If your doctor determines it’s necessary, you can get an extra 36 sessions. If you need intensive rehab, Medicare will cover 72 sessions. You can go to six one-hour therapy sessions a day. You must attend all your sessions within an 18-week timeframe.

Does Medicare pay for a lipid panel?
Every five years, Medicare covers cardiovascular screening through a lipid panel.
Does Medicare cover heart bypass surgery?
Medicare does cover heart bypass surgery. Also, you would have coverage for a triple bypass surgery since these are both life-saving procedures.
Does Medicare cover a stress test?
Yes, Medicare covers a cardiac stress test and cardiac catheterization for people with heart disease. Also, coverage is available for stress tests when a doctor believes a patient has heart disease.
Does Medicare cover a nuclear stress test?
If a doctor orders a nuclear stress test to diagnose you or rule out an illness, Medicare will cover the test.

How to Find a Medicare Cardiologist Near Me

Healthcare can be costly, especially if you don't have the right insurance. Don't wait for a catastrophic event. If you become chronically ill, you might not be able to get a Medigap plan. Outside of the Medigap Open Enrollment Period, you'll buy a plan with your health; if unhealthy, they can raise the premium or deny you.

Let our team find the best Medigap policy for you. We can provide you with several quotes. And, we can identify the company most likely to approve your applications, even if you have a pre-existing condition!

Give us a call at the number above or fill out an online rate form to see what the rates look like for cardiologist Medicare benefits in your area!

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Kayla Hopkins

  • Content Editor

Kayla Hopkins is an accomplished writer and Medicare enthusiast serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.

12 thoughts on “Finding a Medicare Cardiologist

  1. I am going to get a stent in a couple weeks. This will be a preventive stent, as my artery is 60% blocked. Will Medicare cover this?

    1. Paul, if this procedure has been deemed medically necessary by your physician, it will be covered by Medicare. However, it is recommended to check with your doctor and Medicare regarding coverage before having any procedures.

  2. A friend who says she has inside healthcare information due to her job says that as of 2023, under the “Cares” Act that Cardiac catheterization will no longer be covered. Is this accurate? Thanks so much.

    1. There has been no official statement from Medicare regarding this topic. However, if news does break, we keep our pages as up to date as possible.

  3. I have heart problems from triple by pass in 2012 and stent in LAD in 2019. I also suffer from type 2 Diabetes. Also i was diagnosed with Cirrhosis of the liver last year. Should i consider a Medicare Advantage plan or stay with traditional Medicare with a supplemental plan?

  4. Lindsay-I am a heart patient, with a by-pass surger yin 1998 and stint in 2013. I’m curious if Medicare would cover exercise equipment such as treadmills and stationary bicycles? I’m 71 years old and would like to get something to help me keep my BNP Levels lower than 100 but buying them are very expensive. What’s your take on this?

    1. Hi Steve. Unfortunately, Medicare will not cover exercise equipment. Some supplemental plans do include SilverSneakers which gives you access to a local gym.

  5. Hi Lindsey,
    Can you shed light on what Medicare covers in Cardiac Rehabilitation. Additionally, can you give an explanation as to the details of coverage for CABG and stent…coverage in cardiac rehab for life. Lastly, can you forward some good websites for detailed explanation of Medicare coverage for cardiac rehab.

  6. Lindsey – help. Wife – now 80 – had aortic valve replacement – bovine valve some 6 years ago. We continue with an excellent cardiologist. A cardiac catheterization was ordered and performed in late 2020. Outpatient. Our insurance Medicare w/United Health Care supplement. Have not seen the catheterization procedure mentioned in any Medicare or UHC monthly insurance reports to us. Today the Hospital sent us a bill for $660.00 – not a problem for us financially. But – bill labeled “All Accounts” Cost – $61,175.50 – WTF. That blows my mind. Insurance adjustment $57,873, insurance pmt. – $2,642.00 – balance $660.00. If this kind of juggling is going on nationwide, looks like a method of falling into a “Non-Profit” Hospital category.

    1. Hi Gordon! Yes, this unfortunately is normal to see. However, if you have a Medigap plan, you should not be responsible for the $660 balance. I would contact the billing department to figure out why your supplement plan did not cover the balance. Depending on the letter plan you enrolled in, you could have some cost-sharing, but that seems high.

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