Does Medicare cover a lipid panel? 

Medicare covers a wide range of screenings for heart disease, including a lipid panel. Lipids belong to a group of organic compounds made up of fat. A standard lipid panel, sometimes called a lipid profile, is a blood test measuring your cholesterol (HDL, LDL and total) and triglycerides (liquid and solid fats). 

The composition of HDL and LDL molecules is protein and fat. HDLs have a higher proportion of protein to fat than LDLs. HDLs remove excess cholesterol from your cells, protecting you from a heart attack or stroke. LDL complexes have a higher proportion of fat, and their accumulation in artery walls triggers chemical reactions leading to arteriosclerosis.  

Lipid panel results combined with factors like age, family history, lifestyle and specific conditions (diabetes and high blood pressure, for example) help your doctor evaluate your risk of a heart attack or stroke. The test falls under Part B cardiovascular disease screenings. As a Medicare member, you are eligible for one lipid panel every five years.  

Types of cardiovascular disease

Cardiovascular disease (CVD) is a condition that impacts your circulatory system, which involves the heart and blood vessels. Your blood vessels are the channels by which blood circulates throughout your body, beginning and ending with your heart. Arteries transport blood away from your heart, and veins move blood toward your heart. 

Coronary heart disease, characterized by narrowed or blocked arteries, is the most common form of CVD. Other heart conditions include congestive heart failure (inability to pump blood normally), arrhythmia (heart rhythm irregularity), congenital heart disease (heart issues at birth) and endocarditis (inflammation within the heart). Risk is associated with lifestyle factors (poor nutrition, low activity, smoking), obesity, high blood pressure and high cholesterol. 

Medicare preventive services to screen for CVD

Medicare Part B (medical insurance) includes preventive services to screen for CVD and help you modify behaviors to lower your risk. Medicare-participating healthcare providers accept assignment from Medicare, so they will not bill you for these no-cost preventive services. Check your network provider directory if you have Medicare Advantage (MA). Medicare Advantage plans will include at least the same services at Original Medicare Part A and Part B, including preventive services, but many MA plans include additional benefits. 

Behavioral therapy and cardiac rehabilitation

Another Medicare benefit to mitigate your CVD risk is behavioral therapy. You are eligible for an annual visit with your primary care physician or other qualified healthcare provider in a doctor’s office or similar setting. The visit may entail checking blood pressure, offering dietary tips and discussing different approaches to lower your risk. There is no cost if you use a provider who accepts assignment. If you’re enrolled in a Medicare Advantage plan, you may have to visit providers within your plan’s network. 

Medicare offers rehabilitation benefits to beneficiaries who have heart disease or had specific cardiac procedures. The programs focus on fitness, education and counseling. Your cost-sharing is the Part B deductible and 20% of the Medicare-approved amount.

Where to get more information

Medicare Advantage (MA) members may have benefits beyond the Original Medicare program. Check your MA Evidence of Coverage for benefits and cost-sharing details. 

If you are searching for information online about heart disease, testing and treatment, worthy resources include the American Heart Association, World Health Organization, and Centers for Disease Control and Prevention. 

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