Medicare pays for many preventive services to detect health problems, and keep you healthy. These include exams, shots, lab tests, and screenings. They also include rehabilitation programs for health monitoring, counseling, and education to help you take care of yourself.
Preventive and screening services are covered under Medicare Part B (Medical Insurance). Screenings for cardiovascular diseases are also included in these services. They cover blood tests for cholesterol, lipid, and triglyceride levels every 5 years, when ordered by a doctor. You usually pay nothing for these screenings, as long as your doctor can accommodate you. The purpose is to detect conditions that may lead to cardiovascular diseases.
You can have screenings more frequently, if your doctor or health care provider recommends you get screenings done more often than what is normally covered by Medicare. Your doctor may also suggest additional tests or treatments that Medicare does not cover. In this case, you may have to pay some or all of the costs. Therefore, it is important to ask your doctor about the prescribed treatments, and also to know if Medicare covers those treatments and tests.
Part B also offers cardiac rehabilitation programs that include exercise, education, and counseling. It also offers intensive cardiac rehabilitation programs that are more rigorous than regular cardiac rehabilitation programs. These programs may be provided in a hospital outpatient facility or in a doctor’s office. To be eligible for the program, you must have a doctor’s referral, and have had one of the following:
- A heart attack in the last 12 months
- Coronary artery bypass surgery
- Current stable angina pectoris
- A heart valve repair or replacement
- A coronary angioplastyor coronary stent
- A heart or heart-lung transplant
- Stable chronic heart failure*
*People with stable chronic heart failure are only eligible for cardiac rehabilitation programs.
For rehabilitation programs, you pay 20% of the Medicare-approved amount if you get the services in a doctor’s office. In a hospital outpatient facility, you pay a copayment to the hospital; the Part B deductible applies.
The costs of screenings and tests can vary, and they can depend on several things: your insurance plan; your doctor’s charges; your doctor’s position on assignments; the type of facility; and the location where you get your screenings, tests or other services. To find out how much your specific tests or services cost, talk to your doctor, or health care provider.
The Affordable Care Act makes many improvements to Medicare. If you have Original Medicare (Part A and B), you can get an annual “Wellness” visit along with the preventive services. Getting, and keeping track of, these services is easier than ever: register at MyMedicare.gov to get direct access to your preventive services information. MyMedicare.gov is your preventive services personalized portal. You can track your services, get access to a 2-year calendar specifying Medicare-covered tests and screenings for which you are eligible, and even print a personalized “on-the-go” report to take to your next doctor’s appointment.
This is not a complete description of Medicare and the services provided. For more information and to speak with a Medicare specialist, contact e-TeleQuote Insurance.