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 Medicare plans you have.
Medicare Part A Coverage for 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.
Medicare Coverage for Outpatient Heart Procedures
Increasingly, routine heart procedures like angioplasties and stents outpatient 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.
Cardiovascular Disease and Medicare Advantage Coverage
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 benefits beyond Medicare. For example, a Medicare 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.
If you still qualify for Medigap, that coverage is consistent and reliable.
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.
Potential Medicare Advantage Costs with Cardiovascular Disease
Let’s say you have an Advantage Plan with a $35 monthly premium and a $6,000 Maximum Out of Pocket. You may think, “wow, an affordable premium.” But, when you get the emergency medical bills, you’re going to say “wow” and not in a pleasant way.
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.
Medicare Supplement Coverage for Cardiovascular Disease
Heart issues can lead to hospital and doctor visits. You may also need medications. Medicare covers the majority of your medical costs.
But, Medicare Supplement plans can reduce your costs. Doctors’ appointments, hospital stays, surgeries, and medications are costly when you’re the one paying for all the services.
Well, Medigap can help you get the care you need with predictable costs.
Cardiovascular Disease Costs with a Medigap 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.
Prescription Drug Coverage 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.
Some of the most common cardiac medications available are:
- ACE Inhibitors
- Cholesterol-Lowering Medications
Monthly premiums generally depend on where you live. But most stand-alone drug plans cost around $30 a month in 2020.
Further, the average monthly price of cardiovascular medications is about $100 a month. But, Part D can help you lower medication costs.
Medicare Coverage for 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 physician accepts Medicare, you won’t pay for this screen. Sometimes, your physician wants more screens than Medicare will cover.
When Medicare doesn’t cover a test, you’ll pay the bill.
Medicare and Cardiovascular Disease FAQ’s
Does Medicare Cover Cardiovascular Behavior Therapy?
Yes, Medicare does cover one time yearly cardiovascular behavioral therapy visit. You’ll pay nothing for this visit.
Does Medicare Cover Open Heart Surgery?
Yes, Medicare will cover an open heart surgery that is necessary. But, Heart surgeries can range anywhere from $30,000 – $200,000.
While there is coverage, you’ll still pay a portion of the bill. Yet, those with a Medigap plan could pay little to nothing for surgery.
If you have a Medicare Advantage plan, you’ll need to contact the company to inquire about costs.
Does Medicare Cover Cardiac Rehabilitation?
Medicare will cover cardiac rehab if your doctor finds it necessary. Rehab services can help reduce risks and improve your health.
Part B will cover two types of cardiac rehab – general and intensive cardiac rehab. Also, Part B will cover general rehab sessions for 1-2 hours per day.
Medicare will cover a total of 36 sessions within a 36-week timeframe. If your doctor determines it’s necessary, you may be able to 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. Medicare requires you to 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. But, your doctor can help you determine when and if you need a lipid panel.
Does Medicare Cover Heart Bypass Surgery?
Medicare does cover heart bypass surgery. Also, Medicare would cover triple bypass surgery since these are both life-saving procedures.
Does Medicare Cover a Stress Test?
Yes, Medicare will cover a cardiac stress test and cardiac catheterization for people with heart disease. Also, Medicare covers stress tests when a doctor believes a patient has heart disease.
Part B covers these services, and you’ll pay a portion of the cost.
Get Started with Your Coverage Today!
Healthcare is costly, especially if you don’t have proper insurance. But, if you have suitable coverage, medical costs can be manageable.
Don’t wait for a catastrophic event to get the coverage you need. Because, quite frankly, you might not be able to get coverage after a health emergency.
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!