If you have heart disease, the cost of treatments, prescription drugs, screenings, and surgery can be significant. Medicare can help offset some of those costs.

Heart disease affects almost half of U.S. adults and is a leading cause of death in the United States. If you have a heart condition, it’s important to choose a Medicare plan that supports your care and treatment.

This article reviews factors to consider when selecting a Medicare plan. It also explains what the different parts of Medicare cover in terms of heart disease screenings, treatments, and ongoing medications.

Screenings can help prevent serious health complications like strokes and heart attacks.

Original Medicare (Part B) covers heart disease screenings like blood tests for triglycerides, lipids, and cholesterol levels.

Medicare covers these screenings once every 5 years. If you have high cholesterol, Medicare Plan B will also cover screenings to monitor your response to treatments.

Medicare also provides coverage for a one-time screening to those at risk of an abdominal aortic aneurysm.

What does it mean to be in network or out of network?

When a healthcare professional, hospital, or pharmacy is part of a Medicare plan, they’re considered in network. If a plan doesn’t cover them, they’re considered out of network.

Before choosing or switching plans, it’s a good idea to check whether your preferred healthcare professionals, hospitals, and pharmacies are in network. Doing so can help you save money and avoid the inconvenience of shopping for new ones.

Cardiovascular behavioral therapy aims to lower your risk of heart and blood vessel disease. Medicare covers one therapy visit each year.

During therapy, your doctor may:

  • check your blood pressure
  • give you eating tips that’s healthy for you
  • review your medication and discuss aspirin if necessary

What are the goals of cardiac rehabilitation programs?

Cardiac rehabilitation programs are activities designed to improve your heart health and reduce your risk of heart condition complications like a stroke or heart attack. Rehab programs may involve:

  • exercise
  • education
  • counseling
  • psychosocial assessment
  • individualized treatment plan

Original Medicare (Part B) covers general and intensive cardiac rehabilitation programs if your doctor refers you and you have any of the following conditions or procedures:

Original Medicare (Part A) covers surgery, procedures, or hospital stays for heart conditions. If your inpatient stay is 60 days or less, you may not need to pay anything. To be covered by Medicare, your inpatient stay must be:

  • in a hospital that accepts Medicare
  • ordered by a doctor who states you need an inpatient stay to treat your condition

What Medicare covers:

  • meals
  • semiprivate rooms
  • general nursing
  • drugs administered during your stay
  • other services and supplies staff uses to treat you

What Medicare does not cover:

  • private nursing
  • a private room (unless ordered by a doctor)
  • a television or phone in your room
  • personal supplies like slippers, toothbrushes, socks, slippers, and razors

What will your Medicare costs be for inpatient hospital care?

In 2024, here’s what you’ll pay:

  • Days 1 to 60: $0 after you meet your Part A deductible (which is $1,632 for 2024)
  • Days 61 to 90: $408 each day
  • After day 90: $816 each day for each lifetime reserve day (up to 60 days over your lifetime)
  • After you use all of your lifetime reserve days: you pay all costs

Original Medicare doesn’t cover heart medication or any other drugs.

If your heart condition requires medication, you’ll need Medicare Part D or a Medicare Advantage plan that also covers medication.

Smoking cessation programs are covered by Original Medicare.

Medicare Part B covers eight counseling sessions per year. If your smoking cessation counselor accepts assignments, these sessions would be free. Accepting assignments means your healthcare professional accepts the Medicare-approved amount as full payment for a covered service.

Medicare Part B may not cover additional sessions, medications, patches, or other interventions.

Some Medicare Advantage plans may also offer tailored smoking cessation programs.

Medicare chronic care management (CCM) helps you receive care for chronic conditions. A Medicare-approved medical professional will need to arrange and supervise this care.

You can qualify for Medicare’s CCM if you have two or more chronic conditions that:

  • are expected to last at least 1 year or are lifelong
  • put you at risk of decline or death

Examples of chronic care conditions include:

Medicare can help you pay for the care and treatments you need if you have a heart condition. It’s advisable to confirm that your healthcare professionals are in the Medicare network and accept assignments. This will help save you money.

You can enroll for a new Medicare plan or switch plans during the open enrollment period from October 15 to December 7. When your new plan’s coverage starts, the old plan’s coverage will end immediately.