Does Medicare Cover Cardiovascular Screenings?
Free preventive services from Medicare can help your physician assess your risk for cardiovascular disease. These services include heart disease screenings, cardiovascular disease risk reduction visits and an ultrasound screening for abdominal aortic aneurysm.
Medicare’s Coverage of Heart Disease Preventive Services
Heart disease is the leading cause of death in the United States for men and women, claiming about 647,000 lives each year, according to the U.S. Centers for Disease Control and Prevention.
- Heart disease screenings
- Cardiovascular disease risk reduction visits
- Ultrasound screening for abdominal aortic aneurysm
If you’re at risk for a heart attack or stroke, you should meet with a health care professional to discuss steps you can take to help prevent these conditions.
High blood pressure, high cholesterol and smoking are three of the biggest risk factors for heart disease.
Making lifestyle changes, such as adapting your diet and exercising more often, are effective ways to help lower your cholesterol and stay healthy.
These Medicare-covered services help you assess your heart health and develop a plan of care with your doctor.
Heart Disease Screenings
Medicare coverage includes a set of blood tests every five years to screen for cardiovascular disease. A complete blood test for cholesterol is also called a full lipid profile.
This preventive service is available to you at no cost.
These screenings include blood tests for cholesterol, lipid and triglyceride levels that help detect conditions that may lead to a heart attack or stroke.
For many people, an elevated blood cholesterol level indicates an increased risk of developing coronary artery disease.
Medicare Part B may help pay for additional blood tests related to monitoring cholesterol if your doctor orders them, but you’ll be responsible for 20 percent of the Medicare-approved cost for additional tests.
Cardiovascular Disease Risk Reduction Visit
Since 2011, Medicare has covered intensive behavioral therapy for cardiovascular disease.
You can receive this free preventive service — also known as a cardiovascular disease risk reduction visit — once a year from a qualified physician or practitioner in a primary care setting.
- Encouraging aspirin use to prevent cardiovascular disease when appropriate for men ages 45 to 79 and women ages 55 to 79.
- Screening for high blood pressure in adults ages 18 and older.
- Intensive behavioral counseling to promote a healthy diet for adults with hyperlipidemia, hypertension, advancing age and other known risk factors.
During your visit, your primary care provider will give you specific and personalized behavior change advice. Together, you’ll select appropriate treatment goals based on your willingness to change the behavior.
You’ll use techniques such as counseling to help you achieve these goals. Your doctor will schedule follow-ups either in person or over the phone to provide ongoing support and adjust the treatment plan as needed.
Aneurysms are thinned out areas in your arteries that cause them to weaken and widen. They are especially dangerous if they rupture.
A tear in your aorta can result in internal bleeding and immediate death.
Medicare Part B will cover a one-time ultrasound screening for abdominal aortic aneurysm, or AAA, for beneficiaries who meet certain criteria.
The evaluation is done with a noninvasive ultrasound and is offered only once under Medicare.
- You have a family history of abdominal aortic aneurysm.
- You’re a man ages 65 to 75 who has smoked at least 100 cigarettes in his lifetime.
- You have other specific risk factors.
A female smoker is not eligible for a free aneurysm screening unless she has a family history of the condition.
Medicare does not offer a free AAA screening in other parts of the body, such as the brain, even if there is a known family history.
6 Cited Research Articles
- Medicare.gov. (2021, February 8). Give your heart some love: prevent heart disease. Retrieved from https://www.medicare.gov/blog/prevent-heart-disease-valentines-day
- U.S. Centers for Disease Control & Prevention. (2020, September 8). Heart Disease Facts. Retrieved from https://www.cdc.gov/heartdisease/facts.htm
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Decision Memo for Intensive Behavioral Therapy for Cardiovascular Disease (CAG-00424N). Retrieved from https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=248
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicare Claims Processing Manual Chapter 18 - Preventive and Screening Services. Retrieved from https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c18pdf.pdf
- U.S. Centers for Medicare & Medicaid Services. (n.d.). National Coverage Determination (NCD) for Lipid Testing (190.23). Retrieved from https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=102
- Medicare.gov. (n.d.). Cardiovascular disease screenings. Retrieved from https://www.medicare.gov/coverage/cardiovascular-disease-screenings