Does Medicare Cover Cardiac Rehab?

Medicare Benefits Solutions
Aug 3, 2022

Cardiovascular health has become more challenging as more and more people rely on processed foods for their nutritional intake. Technology and innovation have led to more sedentary lifestyle habits that can be difficult to overcome in an age of convenience.

Unfortunately, these factors can lead to heart disease, poor circulation and even heart attacks that require cardiac rehab.

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Does Medicare Pay for Cardiac Rehabilitation?

Thankfully, Medicare does provide coverage for cardiac rehab programs as long as you experience one or more conditions for coverage.

These conditions may include:

  • Having a heart attack within the past 12 months
  • Coronary angioplasty procedure
  • Coronary bypass surgery
  • Coronary stent placement
  • Stable chest pain (angina)
  • Heart valve repair or replacement
  • Heart or lung transplant
  • Ongoing heart failure condition

In terms of coverage, Medicare benefits are provided through Medicare Part B for all outpatient and lab services. This includes visits to your doctor or cardiologist as well as services provided through physical therapy and counseling. If services are provided while you are admitted for inpatient care, Medicare Part A supplies coverage as it covers hospital services and services provided by skilled nursing facilities.

Medications that are prescribed to aid in cardiac rehab are covered by Medicare Part D as long as the medications are listed in your plan’s formulary and are available for purchase from a retail pharmacy. Medicare recipients who are prescribed drugs that are not covered, but for which no alternative exists, may be able to file a waiver for an exception.

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What is Involved in Cardiac Rehab?

Cardiac rehab is a process that is unique to each individual since no two cardiac incidents are exactly the same. There are a number of different factors that can play a role in the development of heart problems, and that will determine what goes into rehabilitation after a heart health concern.

Basic cardiac rehab considerations:

  • Exercises and activities to help promote heart health
  • Education to help you manage cardiovascular risk factors
  • Counseling or therapy to help you better manage stress
  • An individualized treatment plan tailored to your specific needs

In some cases, physical rehabilitation will be needed in order to exercise the heart in a safe manner to help it build strength for normal operation. In other situations, breathing therapies may be required to assist the heart, lungs and vascular structures to work more efficiently in transferring oxygenated blood.

Counseling for stress is another aspect of cardiac rehab that plays an important role in strengthening a weakened heart. After a cardiac incident, the heart muscle can be damaged so severely that elevated stress levels can lead to another episode. By managing stress through counseling and therapy, the heart has a chance to heal and build strength safely and effectively.

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Medicare Benefits and Heart Surgery

It’s also worth noting that Medicare also provides benefits for surgery related to cardiac health preceding cardiac rehab. Medicare Part A provides coverage for services like heart transplant surgery and heart bypass surgery in most cases. But, Medicare recipients may also be able to receive coverage for corrective surgery and valve replacement.

In most cases of cardiac surgery, you will need to be formally admitted into a hospital and spend time in a hospital and/or a skilled nursing facility for recovery and monitoring, and the services you receive during this time would be covered by Medicare Part A.

Comparing Medicare Plans

Did you know that we have a helpful tool to help you choose the best plan? Our Medicare Plan Finder lets you compare plans side-by-side, find additional benefits, check if your doctors are included and much more. Try plan finder today!

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