Does Medicare Cover Cardiac Rehab?

Cardiovascular health has become more challenging as more and more people rely on processed foods for their nutritional intake. Technology, innovation, and Amazon prime 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.

Medicare Benefits Solutions

Mar 21, 2021

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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. 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.

Does Medicare cover cardiac rehab?

Thankfully, Medicare does provide coverage for cardiac rehab programs as long as certain conditions have been met. These conditions may include having had a heart attack within the last 12 months, having had coronary bypass surgery, having had a heart transplant or having an 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.

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 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.

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