Medicare covers both inpatient and outpatient services for those with cardiovascular disease. Medicare coverage to prevent and treat cardiovascular disease is also available. Some screenings are under Part B. Part A covers hospitalization for a heart attack, stroke, heart surgery as well as rehabilitation. Your exact coverage will depend on your condition and the type of plan you have.
Does Medicare Cover Cardiovascular Disease?
Many people wind up staying in a hospital due to their cardiovascular disease. Whether you suffer a heart attack or need surgery, you could need inpatient care.
Part A covers hospitalization for a heart condition, heart surgery, and stroke. Part A has a deductible and coinsurance costs that are your responsibility.
Coverage includes prescriptions, equipment, tests, therapies, nursing care, the operating room, and a semi-private hospital room. Also, you may be eligible for Chronic Care Management, talk to your doctor about your options.
Does Medicare Cover Outpatient Heart Procedures?
Preventative services may include:
- Aneurysm Screens
- Cholesterol Screens
- Blood Pressure Screens
Outpatient services may include:
- Cardiac Catheterizations
While preventive services have total 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.
Does Medicare Cover Heart Stents?
Carotid artery stenting is not covered by Medicare without emblic 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 emblic protection devices.
Does Medicare Advantage Cover Cardiovascular Disease?
Advantage plans must cover at least as good as Medicare. Yet, restrictions like doctor networks come along with this plan type.
But, many Advantage plans include extra benefits. For example, an Advantage plan could consist of a gym membership.
These plans must cover Cardiovascular screenings 100%, the same as Medicare. But, you’ll have a bill for diagnostic care and treatments.
Each company and plan is different depending on your location. Plus, the plans change each year during the Annual Enrollment Period.
But, if you don’t qualify or the cost is too high, there may be a Medicare Advantage Special Needs Plan for Chronic Heart Conditions. Some locations don’t have this option, but if your area does, it’s worth considering.
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.
First, if you take an ambulance, it’ll cost YOU between $150-$300 or more in copayments. Then, the hospital costs are usually about $300-$600 each day for five to eight days.
Once you spend $6,000 on medical services, the plan approves, then they’ll cover your medical bills in full. But, that’s quite a bit, and the Maximum Out of Pocket resets every year on January 1st.
Considering a Medigap plan on average costs about $150-$200 a month, that’s way more affordable than $6,000 for the year.
Now, if you don’t qualify for Medigap, an Advantage plan can offer more protection than Medicare.
Do Medicare Supplements Cover Cardiovascular Disease?
Yes, Medicare Supplement plans can reduce your costs. Doctors’ appointments, hospital stays, surgeries, and medications are costly, even after Medicare pays their 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?
What Cardiac Medications Does Medicare Cover?
- ACE Inhibitors
- Cholesterol-Lowering Medications
Monthly premiums generally depend on where you live. But most stand-alone drug plans cost around $30 a month.
Further, the average monthly price of cardiovascular medications is about $100 a month. But, Part D can help you lower medication costs.
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.
Get Started with Your Cardiovascular Disease Coverage Today!
Healthcare is costly, especially if you don’t have proper 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 in your area!