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Navigating Medicare can be confusing, especially if you are dealing with a chronic condition. If you have or are at risk of chronic cardiovascular disease, your health may require additional support than is available through Original Medicare. Learning about your coverage and benefit options with Medicare can help you make an informed decision.

Original Medicare and Heart Disease (Cardiovascular Disease) Coverage

Medicare Parts A and B will cover some services if you are at risk of, or have, cardiovascular disease or have suffered a heart attack.

Medicare Part A (hospital coverage) will cover inpatient care. For example, Part A will cover heart bypass surgery. Like all Medicare-covered services, your cost of heart bypass surgery with Medicare is the 20 percent coinsurance. Medicare Part A will also cover an implantable defibrillator if you have been diagnosed with heart failure and the procedure takes place in a hospital.

senior female patient with nurse

Medicare Part B (medical insurance) will cover:

  • Cardiovascular disease screening (once every 5 years)
    • Blood tests to detect cardiovascular conditions
  • Cardiovascular behavioral therapy (once per year)
    • Therapy to help lower your risk for cardiovascular disease
  • Cardiac Rehabilitation, if you meet eligibility requirements
    • Exercise, education and counseling after a heart attack, heart transplant, coronary artery bypass surgery, chronic heart failure, angina, or coronary angioplasty.
  • Implantable defibrillator, if you have been diagnosed with heart failure and the procedure takes place in an outpatient setting

For all covered Medicare services, you are responsible for the 20 percent Medicare coinsurance.

It’s important to note that if you are at risk, your doctor may recommend screening more often than Medicare covers. In that case, you will be responsible for 100 percent of the non-covered cost.

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Additional Benefits with Medicare Advantage

Original Medicare (Parts A and B) does not include coverage for numerous important benefits that individuals dealing with heart and cardiovascular disease may desire, including:

  • Vision
  • Dental
  • Hearing
  • Prescription Drugs
  • Home Health Care Services
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Medicare Advantage Part C is offered by private insurance companies and includes all of the coverage of Original Medicare. Many Medicare Advantage plans come with additional coverage, like the ones listed above, as well as potential additional savings. Because many Medicare Advantage plans include Part A, Part B, Part D, as well as additional benefits in a single plan, you may find that managing your Medicare coverage is more convenient.

If you have or are at risk of cardiovascular disease, you may find that a Medicare Advantage plan is financially beneficial. Many Medicare Advantage plans are known to have low to no cost premiums, deductibles or copayments. You will still be responsible for the Part B premium. Because many Medicare Advantage plans include Part D prescription drug coverage, you may find that your prescription medications cost less.

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Chronic Special Needs Plans (C-SNP) for Heart Disease and Cardiovascular Disorders

Some Medicare Advantage plans are designed to cater to people with specific chronic conditions. These plans are called C-SNPs. Some plans are geared toward heart disease and cardiovascular disorders, which means they may offer better access to cardiology specialists and cover common prescriptions used by individuals with a heart or cardiovascular disease.

Frequently Asked Questions

What is considered cardiovascular disease?

Cardiovascular disease is an umbrella term that can refer to several conditions, including:
·Heart Disease
·Heart failure
·Cardiomyopathy
·Coronary artery disease
·Angina
·Tachycardia
Some Medicare Advantage C-SNPs cater to specific cardiovascular conditions.

Does Medicare cover blood pressure monitors?

Unless you meet specific criteria, Medicare does not cover blood pressure monitors. You are responsible for 100 percent of the non-covered equipment or services.

Does Medicare cover heart bypass surgery?

Yes. Medicare Part A will cover heart bypass surgery. However, like all Medicare-covered services, you are still responsible for the 20 percent coinsurance.

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Last Updated: November 1, 2022 MULTIPLAN_ETQEZMwebsite_0722_M