February is American Heart Month, a time to focus on one of the most important parts of our well-being: cardiovascular health. Heart disease is the leading cause of death among adults over age 65, but the good news is that early detection and proper management can make a significant difference.
For Medicare beneficiaries, understanding how their coverage supports heart health can help them take advantage of preventive services, manage existing conditions, and avoid costly surprises. Let’s look at how Medicare covers cardiovascular care and how you can make the most of these benefits.
Why Heart Health Matters for Medicare Beneficiaries
Heart disease affects millions of older adults each year, and conditions like high blood pressure, high cholesterol, and coronary artery disease become more common with age. Many of these issues develop gradually, often without symptoms, which is why regular checkups and screenings are essential.
Medicare plays a major role in supporting heart health. The program covers preventive services to catch problems early, treatment for those who have already been diagnosed, and prescription medications to help manage ongoing conditions. Using these benefits proactively can help seniors maintain better health and avoid hospitalizations.
Preventive Heart Screenings Covered by Medicare
Preventive care is one of the most valuable aspects of Medicare coverage. Under Medicare Part B, many screenings and tests that assess heart health are covered in full when performed by a provider who accepts Medicare assignment.
For example, Medicare covers cholesterol and lipid screenings every five years to identify cardiovascular disease risk. Routine blood pressure checks during doctor visits are also covered and can help detect hypertension before it causes complications. Beneficiaries who are overweight can receive obesity screening and counseling to support weight management, a key part of maintaining a healthy heart.
Because diabetes is closely linked to heart disease, Medicare also provides coverage for diabetes screenings for those at risk. And through the Annual Wellness Visit, beneficiaries can discuss their heart health, review risk factors, and create a plan for staying active and healthy.
These preventive services come at no cost to the patient when they are performed by a participating Medicare provider. Taking advantage of them can help identify potential issues early, when they are easier and less expensive to manage.
Medicare Coverage for Heart Disease Treatment
When a beneficiary is diagnosed with heart disease or experiences a cardiac event, Medicare provides comprehensive coverage for treatment.
Medicare Part A covers inpatient hospital care for heart-related conditions such as heart attacks, bypass surgery, or stent placement. It also includes medically necessary cardiac rehabilitation after a hospital stay, helping patients regain strength and recover safely. Part A typically covers the hospital room, nursing care, and medications received during the stay, though beneficiaries will need to meet the annual deductible and may owe coinsurance depending on the length of their hospitalization.
Medicare Part B covers outpatient services, including doctor visits, diagnostic tests, and follow-up care. This includes services like electrocardiograms (EKGs), echocardiograms, and stress tests, as well as up to 36 sessions of cardiac rehabilitation if prescribed by a physician. After meeting the annual Part B deductible, patients usually pay 20% of the approved cost for these services.
Prescription medications are an essential part of managing heart disease, and that’s where Medicare Part D comes in. Part D plans cover most medications used to treat heart conditions, such as statins to lower cholesterol, beta blockers and ACE inhibitors to control blood pressure, and anticoagulants to prevent blood clots. Because coverage and prices can vary, it’s wise to review your plan’s formulary each year to make sure your prescriptions are still covered and affordable.
Medicare Advantage and Heart Health
Those enrolled in Medicare Advantage (Part C) receive all the same hospital and medical coverage as Original Medicare, but many plans go a step further by offering additional wellness benefits.
Depending on the plan, members may have access to fitness programs like SilverSneakers, nutrition or meal delivery benefits, and disease management programs that provide extra support for chronic conditions such as heart failure or diabetes. Some plans also offer telehealth visits, making it easier for beneficiaries to stay in touch with their doctors without leaving home.
Because these extra benefits vary by plan, it’s important to review your coverage each year to ensure you’re getting the support and services that best fit your needs.
Extra Help for Managing Heart Health
Beyond standard Medicare coverage, there are several programs designed to help beneficiaries manage chronic heart conditions and reduce their out-of-pocket costs.
One example is Chronic Care Management (CCM), a service many primary care providers offer for patients with multiple chronic illnesses. CCM provides ongoing coordination between your doctors and helps track medications and symptoms between visits.
Medicare also covers smoking cessation counseling, which can make a big difference in lowering heart disease risk. And for those who qualify based on income, the Extra Help program can reduce the cost of prescription medications, a big relief for patients taking several heart-related drugs each month.
These additional resources are often underused, but they can have a real impact on both health outcomes and financial peace of mind.
How to Make the Most of Your Medicare Heart Benefits
Taking full advantage of your Medicare benefits can go a long way toward protecting your heart health. Schedule your Annual Wellness Visit each year and ask your provider to review your cardiovascular risk factors. If you take heart medications, review your Part D plan annually to confirm your prescriptions are still covered at the best price.
If you have a Medicare Advantage plan, explore the wellness and fitness programs it may offer. Staying active, maintaining a healthy diet, and managing your blood pressure and cholesterol all contribute to a stronger heart. And if you’re not sure whether you’re getting the best value from your Medicare plan, don’t hesitate to ask for guidance. An independent Medicare agency like Carolina Senior Benefits can help you review your options and find coverage that supports your long-term health goals.
