Medicare Prevents and Screens for Heart Disease


In the U.S., heart disease remains the number one killer of Americans and as per the Centers for Disease Control and Prevention, one in four deaths is due to some form of cardiovascular disease. In the U.S. it has been determined that around 805,000 people suffer a heart attack and 795,000 people have a stroke every year. Cardiovascular disease if not treated on time can lead to serious health consequences and even death. This ruins people both physically as well as financially. According to the CDC Foundation study, it was estimated that heart disease direct medical costs could reach $818 billion annually by 2030. When an individual’s productivity is added then the loss could further aggravate. Thus, it becomes important to take measures to prevent heart diseases.

Regular exercise, right eating habits, and quitting smoking may help but sometimes heart issues are genetic and so such people are vulnerable to the disease. Therefore, to reduce disease complications and cure them, individuals can opt for preventive screening and early treatment. Thus, to help people out Medicare covers the following tests and treatments, most of them are free but only under certain circumstances.

Aneurysm Screening

Medicare will pay for the abdominal aortic aneurysm’s screening if the doctor is a participating provider. However, the screening is covered only if certain conditions are met, like individuals should have a family history of an aortic aneurysm, or they must be in the age-group of 65-75 years, must have smoked 100 or more cigarettes in his lifetime. However, a female is only eligible for free aneurysm screening if she has a family history. Even if she smokes more than her male counterpart, then also she will not be eligible for free aneurysm screening. People should be aware that Medicare does not offer free screening for aneurysms in other parts of the body.

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Blood Pressure Screening

Hypertension is the greatest factor for heart attack and stroke, putting a large segment of the U.S. population at risk. Unfortunately, hypertension is a silent killer. The majority of people do not feel sick from hypertension. Thus, without proper screening, they are not even aware of the risk. Blood pressure screening and counselling are free for Medicare enrollees and are often routinely included in their office visits too and the doctor is unlikely to charge them for screening.

Cholesterol Screening

Too much cholesterol increases the risk of cardiovascular disease, especially when it builds up in the arteries. The excess cholesterol leads to the formation of plaque, thickened material that obstructs blood flow through the arteries, eventually blocking smaller blood vessels downstream. Thus, the blood supply to the brain or heart may be compromised leading to stroke or heart attack. Thus, people need to manage high cholesterol to decrease the risk for heart disease and so Medicare covers cholesterol screening that is free once in every five years. If any additional screening s required, then people will have to pay out-of-their own pocket. However, it doesn’t mean Medicare will not pay for cholesterol testing more often but it won’t be free. People who are at risk for heart disease, their doctor may order routine blood work twice a year but they will be required to pay a 20% coinsurance for each test.

Medicare and Heart Disease Screening

Heart disease is common in the U.S., as every year, 605,000 Americans experience heart attack for the first time and about 200,000 people are expected to experience it a second time. Some of the common reasons behind heart disease are age, male gender, and race like American, Indian, and Pacific Islanders. Some of the other risk factors are alcohol overuse, high blood pressure, high blood cholesterol, diabetes, and family history of early heart disease.

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One of the ways to screen for heart disease is cardiac stress testing. Then the heart is examined through an electrocardiogram (EKG), echocardiogram (ultrasound of the heart), or nuclear imaging. The pictures of the heart are taken after injecting the patient with a radioactive tracer. This test is followed up with more definitive testing, a cardiac catheterization. Enrollees should be aware that Medicare will not pay for a cardiac stress test without any symptom, as these tests are not performed only for the screening purpose.

Medicare covers cardiac stress testing and cardiac catheterization for people who have either known heart disease or who are suspected of heart disease based on symptoms. Medicare Part B covers these tests and individuals have to pay a 20% coinsurance.

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