Heart disease is the leading cause of death in the U.S. According to the CDC, heart disease is responsible for one out of every four deaths, but people can reduce their risk through lifestyle changes and medicine. Help your Medicare clients get the care they need to keep their hearts healthy.
Prevention and Diagnosis
Under Medicare Part B, cardiovascular behavioral therapy visits are covered once every year, as long as they are carried out with the patient’s primary care doctor or another primary care practitioner in a primary care setting. There is no cost to the patient as long as the patient’s doctor or other qualified health care provider accepts the assignment. During these sessions, the doctor will check the patient’s blood pressure and discuss tips that can help lower a person’s risk for heart disease.
Medicare Part B also covers cardiovascular disease screening blood tests once every five years. Once again, Medicare beneficiaries pay nothing out of pocket for these tests as long as a doctor or other qualified health care provider accepts the assignment. The blood tests check cholesterol, lipid, and triglyceride levels, which can indicate dangerous health conditions that could lead to a stroke or heart attack.
If your clients have not taken advantage of these free benefits, remind them to do so.
Doctors may recommend additional tests, especially for patients with certain risk factors. These tests may not be covered by Medicare, however, so your clients may have to pay out of pocket to have them done.
Coverage for Care
For patients with heart disease, coverage is available under the different parts of Medicare.
For example, if a patient experiences heart failure and needs an implantable automatic defibrillator, Medicare Part A covers surgery performed in a hospital inpatient setting, while Medicare Part B covers surgery performed in a hospital outpatient setting.
Medicare Part B also covers a cardiac rehabilitation program for eligible patients. These programs can include exercise, education, and counseling.
Medicare Advantage and Special Needs Plans
Patients with heart disease may find better coverage under Medicare Advantage plans. In addition to looking at the regular Medicare Advantage plans in the area, your clients may want to look for Special Needs Plans.
Special Needs Plans are Medicare Advantage plans designed for specific groups. Chronic Conditions Special Needs Plans, or C-SNPs, provide care for enrollees with certain health conditions, which may include cardiovascular disorders and chronic heart failure. All C-SNPs include prescription drug coverage, and they may include extra benefits to help with the condition they serve.
If your client has a cardiovascular disorder or chronic heart failure, and if there’s a C-SNP in the area that caters to the condition, enrollment is possible at any time of the year.
