Medicare’s Coverage of Heart Conditions

Cardiovascular treatments help identify, treat and manage heart and blood vessel conditions. Original Medicare (Part A and Part B) covers cardiology treatments if the patient has experienced certain conditions. Medicare Advantage (Part C) will cover everything included under Original Medicare and may offer additional benefits.

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    Lindsey Crossmier

    Lindsey Crossmier

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    Lindsey Crossmier is an accomplished writer with experience working for The Florida Review and Bookstar PR. As a financial writer, she covers Medicare, life insurance and dental insurance topics for RetireGuide. Research-based data drives her work.

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    Savannah Pittle
    Savannah Pittle, senior financial editor for RetireGuide

    Savannah Pittle

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    Christian Worstell
    Christian Worstell, Medicare expert

    Christian Worstell

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  • Published: March 25, 2022
  • Updated: October 23, 2023
  • 7 min read time
  • This page features 19 Cited Research Articles
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A licensed insurance professional reviewed this page for accuracy and compliance with the CMS Medicare Communications and Marketing Guidelines (MCMGs) and Medicare Advantage (MA/MAPD) and/or Medicare Prescription Drug Plans (PDP) carriers’ guidelines.

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APA Crossmier, L. (2023, October 23). Medicare’s Coverage of Heart Conditions. Retrieved June 17, 2024, from

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Chicago Crossmier, Lindsey. "Medicare’s Coverage of Heart Conditions." Last modified October 23, 2023.

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Heart Conditions Covered Under Medicare

Medicare helps cover costs associated with detecting, diagnosing and treating heart conditions. The most common heart condition covered under Medicare is coronary artery disease.

Some patients can manage their heart conditions with healthy lifestyle choices, but others may need surgeries and medications to improve. Medicare benefits are available in both situations.

Each part of Medicare provides different heart disease coverage, including benefits for diagnostic screenings, treatments and medications.

According to the Centers for Disease Control and Prevention, half of all Americans have at least one risk factor — either high blood pressure, high cholesterol or smoking — for heart disease.

Common Types of Heart Disease Covered Under Medicare
Coronary Artery Disease
Plaque buildup damages or blocks major blood vessels, limiting blood flow to the heart
Peripheral Artery Disease
Blood vessels that supply blood to your limbs become blocked
Atrial Fibrillation
Issues with the electrical conduction system of your heart cause abnormal heart rhythms
Heart Failure
Issues with heart pumping/relaxing functions lead to fluid buildup and shortness of breath
Source: Cleveland Clinic

If your heart disease is less common, you may be eligible for Medicare coverage if the condition is life-threatening.

Heart disease is among the leading causes of death for older Americans. Use your Medicare benefits to your advantage to help detect, treat and recover from a heart condition while maximizing your health care savings.

Cardiovascular Disease Prevention & Screenings Covered Under Medicare

Medicare covers many preventive services and screenings for cardiovascular diseases at no cost. Your exams and lab tests are all included in your benefits.

One of the ways doctors diagnose a cardiovascular disease is through blood tests that screen for cholesterol, lipid and triglyceride levels. Part B covers cardiovascular screening blood tests every five years.

Other preventive measures include cardiovascular disease risk reduction visits or ultrasound screening for abdominal aortic aneurysm. Medicare will also pay for intensive behavioral therapy for cardiovascular disease annually.

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Cardiovascular Procedures Covered Under Medicare

Cardiovascular procedures, such as open heart surgery and heart transplants, are generally considered medically necessary to protect your health and will be covered by Medicare in most cases.

Make sure your doctor, hospital or facility is enrolled in Medicare and accepting new Medicare patients before starting your treatment.

Open Heart Surgery

Medicare covers open heart surgery, even if your plan doesn’t specifically mention open heart or bypass surgery coverage. Open heart surgery is typically considered medically necessary, so Medicare will cover your treatment and rehabilitation.

Medicare Part A will cover the Medicare-approved amount for hospitalization costs, such as a semi-private room, medications and meals, once you’ve met your deductible of $1,632 in 2024. You will be responsible for coinsurance costs if you are an inpatient for more than 60 days.

Medicare Part B will cover 80% of your doctor visits, tests and cardiac rehab once you’ve paid the Part B deductible.

Heart Valve Replacement

Medicare will cover Transcatheter Aortic Valve Replacement, or TAVR, when performed for an FDA-approved indication, when part of an approved clinical study or with the collection of additional clinical data.

TAVR is a procedure to treat aortic stenosis, a condition in which the aortic valve becomes narrowed and cannot properly send blood from the heart to the rest of the body. Doctors replace the diseased aortic valve with a man-made valve.

To qualify for Medicare benefits for TAVR, you must be under the care of a heart team that includes a cardiac surgeon and an interventional cardiologist. The heart team and the hospital where the team performs the procedure must meet certain criteria, such as participation in a TAVR registry.

Heart Transplants

Original Medicare will cover the majority of heart transplant costs for procedures performed at a Medicare-approved facility. If you meet certain conditions, Medicare will help pay for doctors’ services, procurement of the donor heart, immunosuppressive drugs, follow-up care, and necessary tests, labs and exams.

You will be responsible for your Part B deductible, 20% of the Medicare-approved amount for your doctor’s services and various transplant facility charges. You likely won’t owe anything to the donor or for the Medicare-certified laboratory tests.

For Medicare to cover the immunosuppressant, or transplant, drugs, it must have also covered the surgery, or an employer or union group health plan must have been required to pay before Medicare paid for the transplant. Additionally, you must have Part B when you receive the drugs, and you must have had Part A when you underwent the transplant.

Medicare's Coverage of Cardiac Rehab

Cardiac rehab is a medically supervised program. Medicare Part B will pay for cardiac rehab if you have had a specific cardiac condition or procedure, such as a heart attack in the last 12 months, a coronary artery bypass surgery, a heart valve repair or replacement, or a transplant.

The programs for cardiac rehab typically include exercise, education and counseling. There are two types of cardiac rehab: intensive and regular.

Differences Between Regular and Intensive Cardiac Rehabilitation

Regular Cardiac Rehab
  • Typically exercise focused
  • Training sessions typically last 1 hour per day
  • Slower paced, normally with one training session per day
Intensive Cardiac Rehab
  • Equally covers exercise, nutrition education, stress management and social support
  • Training sessions are fast-paced and longer than 1 hour
  • Multiple training sessions available per day
  • Proven to be more effective than regular cardiac rehab
Source: Bowling Green State University

Part B will cover 80% of the cardiac rehab programs once you’ve met your deductible of $240 in 2024. If you have a Medicare Advantage plan, or Medicare Part D, your medications will likely be covered as well.

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Medicare's Coverage of Blood Pressure Monitors and Implantable Devices

For Medicare beneficiaries with suspected hypertension or who are at high risk of cardiac arrest, monitoring their blood pressure at home or receiving an implantable automatic defibrillator may be necessary for diagnosing and managing an ongoing health condition.

Fortunately, Medicare provides benefits to beneficiaries who need this equipment to maintain their wellbeing. Depending on your plan, provider and health status, Medicare may help pay for your equipment and any surgery needed to implant it.

At-Home Blood Pressure Monitoring

Medicare does not cover standard blood pressure monitors, commonly referred to as cuffs, except for people undergoing dialysis at home. However, it will cover ambulatory blood pressure monitoring (ABPM) for patients with suspected “white coat hypertension” and “masked hypertension.”

White coat hypertension refers to artificially high blood pressure readings, usually caused by anxiety, when a patient is in a doctor’s office. Masked hypertension is the opposite; it occurs when a patient’s blood pressure readings in a doctor’s office are lower than readings taken outside of the clinical setting.

CMS expanded coverage of ABPM in 2019 to include both indications.

ABPM allows doctors to assess patients’ blood pressure as they go about their normal daily activities versus when they’re sitting in a doctor’s office. It’s a noninvasive diagnostic test in which the patient wears a cuff on their arm and attaches a recording device to their belt or clothing.

The device tracks blood pressure over 24-hour cycles when the patient is awake and sleeping.

A licensed physician must prescribe the device and Medicare must agree that the device is medically necessary and proper for it to be covered. And the provider who supplies the device must participate in Medicare.

If you rent the device from a Medicare-certified medical equipment provider, Medicare Part B will pay 80% of the Medicare-approved amount. To avoid extra out of pocket costs, make sure the supplier is a Medicare “participating supplier.” A supplier who’s enrolled in Medicare but isn’t an officially participating supplier may charge more than the Medicare-approved amount, leaving you to pay the difference.

Implantable Devices

If you’ve been diagnosed with heart failure, you may qualify for Medicare to cover an implantable automatic defibrillator.

Medicare Part A will pay for the surgery to implant the defibrillator if you are admitted to the hospital as an inpatient. Medicare Part B will pay for the surgery if you get the device as a hospital outpatient.

If the surgery takes place in a hospital outpatient setting, you will owe the hospital a copayment. The copayment will not exceed the deductible you would have owed under Part A for an inpatient hospital stay.

You will also be responsible for 20% of the Medicare-approved cost for your doctor’s services once you have met your Part B deductible.

Implantable defibrillators are different from pacemakers, which are covered as prosthetic devices under Medicare. The device must be a reasonable and medically necessary treatment for Medicare to cover it.

Because pacemakers are categorized as durable medical equipment, Medicare Part B will cover 80% of the approved amount for the device after you’ve met your deductible.

Last Modified: October 23, 2023

19 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from
  2. U.S. Centers for Medicare & Medicaid Services. (2022). Costs. Retrieved from
  3. Centers for Disease Control and Prevention. (2022, February 7). Heart Disease Facts. Retrieved from
  4. MedlinePlus. (2022, February 4). Blood pressure monitors for home. Retrieved from
  5. National Library of Medicine. (2022, February 4). Heart valve surgery. Retrieved from
  6. Cleveland Clinic. (2021, October 5). Cardiovascular Disease. Retrieved from
  7. Centers for Disease Control and Prevention. (2021, September 27). Atrial Fibrillation. Retrieved from
  8. Centers for Disease Control and Prevention. (2021, May 18). High Blood Pressure Symptoms and Causes. Retrieved from
  9. Thatcher, J. (2021, April 14). Comparison of Traditional Cardiac Rehabilitation Programs With Intensive Cardiac Rehabilitation Programs on Health Outcomes in Cardiac Patients. Retrieved from
  10. MedlinePlus. (2021, March 30). Pacemakers and Implantable Defibrillators. Retrieved from
  11. Centers for Disease Control and Prevention. (2020, September 30). Prevent and Manage High Blood Pressure. Retrieved from
  12. Centers for Disease Control and Prevention. (2019, December 9). Know Your Risk for Heart Disease. Retrieved from
  13. Centers for Medicare and Medicaid Services. (2019, July 2). CMS Expands Coverage of Ambulatory Blood Pressure Monitoring (ABPM). Retrieved from
  14. John Hopkins Medicine. (2019). Congestive Heart Failure: Prevention, Treatment and Research. Retrieved from
  15. Centers for Medicare and Medicaid Services. (May 2012). Transcatheter Aortic Valve Replacement (TAVR). Retrieved from
  16. Everly, M. (2008). Cardiac transplantation in the United States: an analysis of the UNOS registry. Retrieved from
  17. Centers for Medicare and Medicaid Services. (n.d.). Cardiovascular disease screenings. Retrieved from
  18. Centers for Medicare and Medicaid Services. (n.d.). Defibrillators. Retrieved from
  19. Centers for Medicare and Medicaid Services. (n.d.). Your Medicare Coverage. Retrieved from