Does Medicare cover cardiac rehab? 

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The National Center for Biotechnology Information reports that cardiovascular disease (CVD) is the leading cause of death in the U.S. and one of the chief causes of death across the globe. Customized cardiac rehabilitation for patients with specific heart problems can improve cardiovascular function, reducing mortality risk and enhancing quality of life. 

Medicare cardiac rehabilitation benefits

Cardiac rehabilitation entails exercise, counseling and education, according to individual needs. The Medicare benefit includes standard and intensive programs. If you qualify, Part B covers 20% of the Medicare-approved charges for rehab in a doctor’s office, but you must first satisfy the Part B deductible. If you choose to have rehab in a hospital outpatient center, the facility may charge you a copayment.

The cardiac rehabilitation benefit is available if you experience at least one of the following heart conditions or procedures: 

  • Coronary bypass surgery
  • Heart attack within the last year
  • Current chest discomfort (stable angina pectoris)
  • Medical procedure to open a blocked artery (angioplasty) or keep it open (stenting)
  • Heart valve replacement or repair
  • Heart transplant
  • Heart-lung transplant
  • Stable chronic heart failure

If you have Original Medicare and have purchased Medicare Supplement (Medigap) insurance, you may have additional coverage. 

Medicare preventive services for CVD health

In addition to cardiac rehabilitation, Medicare offers preventive services to help you lower your risk of CVD. Medicare covers the cost if you use a qualified healthcare provider who accepts assignment. Participating Medicare providers must accept assignment, meaning they submit claims to Medicare directly, accept the Medicare-approved payment and do not bill you additional charges. 

Cardiovascular behavioral therapy includes an annual doctor visit in a primary care setting, such as a doctor’s office, where you can get a blood pressure reading and discuss positive behaviors for keeping your heart healthy. Cardiovascular disease screenings are blood tests to detect high cholesterol, lipids and triglycerides. Medicare benefits include CVD blood test screenings once every five years.

If you have Medicare Advantage (MA), you may have to visit providers within the plan’s network. You may also browse the benefit summary to check for additional benefits that Original Medicare does not cover, such as an annual routine physical exam with bloodwork.  

Adopting a healthy lifestyle

High blood pressure (HBP), or hypertension, is when the force of blood flowing through your blood vessels is elevated consistently above a normal range. Over time, HBP can lead to a heart attack, stroke, heart failure, kidney disease and other health issues. The American Heart Association calls high blood pressure the silent killer because it often presents no symptoms. Visit heart.org to learn about small lifestyle changes that may lower your blood pressure and protect your heart.

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