Medicare offers coverage for various heart disease screenings, rehabilitation, and behavioral training. The amount that Medicare will cover depends on the type of preventive services and treatment covered by your plan, as well as your specific health needs.

“Heart disease” is a broad term that covers a range of health conditions that can affect your heart, such as:

According to the Centers for Disease Control and Prevention (CDC), heart disease is a leading cause of death for both women and men in the United States.

Read on to learn more about the services related to heart disease that Medicare does and doesn’t cover.

Generally speaking, Medicare covers the following medical services that may help with preventing, diagnosing, treating, and managing heart disease:

Original Medicare is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). Medicare Part B covers cardiovascular screening blood tests for:

Medicare covers these tests once every 5 years. The results can help doctors identify risk factors or conditions that may lead to stroke or heart attack.

If your doctor accepts the Medicare-approved rate payment in full, you won’t have to pay anything for these screenings.

You may also get a screening for aneurysm if you have a family history of aortic aneurysm or if you’re a male between ages 65 and 75 years and smoke or have a history of smoking at least 100 cigarettes in your lifetime.

People often take prescription medications to manage or treat heart disease. But Original Medicare (parts A and B) doesn’t cover prescription maintenance drugs.

If you have Original Medicare and need prescription drug coverage, you can enroll in a Medicare Part D plan. Part D plans are available from private companies that Medicare has vetted. Part D plans have a formulary (list) of covered drugs, and your out-of-pocket cost will depend on the tier your drug is listed in.

Another option is to enroll in a Medicare Advantage (Part C) plan. These plans are “all-in-one” replacements for Original Medicare, and many of them include prescription drug coverage. They are also available through private insurance providers.

Medicare covers rehabilitation programs for qualifying conditions. These programs include:

  • counseling
  • exercise
  • education

Qualifying conditions or treatments for rehabilitation program coverage (Part B) include:

Medicare Part B also covers some intensive cardiac rehabilitation programs if your doctor has referred you. These programs typically include a more intense physical workout, as well as counseling and education.

If you get these services in a hospital setting, you’ll be responsible for paying the hospital a copayment of the Medicare-approved amount.

If you get these services in a doctor’s office, you be responsible for paying 20% of that amount. This applies after you’ve met your Medicare Part B deductible ($240 in 2024).

Each year, Medicare Part B will cover one session of cardiovascular behavioral therapy with your doctor.

This therapy is designed to help you lower your risk of cardiovascular disease. It may include, among other things, a blood pressure check and information on heart-healthy eating.

If your doctor accepts the Medicare-approved amount, you won’t need to pay anything for this therapy.

Medicare may cover certain costs if you have two or more serious chronic conditions expected to last a year or longer. Some conditions that Medicare considers to be chronic include:

Visit the CMS Chronic Conditions Data Warehouse website for a starting list of additional chronic conditions.

You may be covered for aspects of a comprehensive care plan that includes:

  • health concerns and goals
  • healthcare professionals
  • medication management
  • 24/7 access to urgent care
  • available community services

Talk with your doctor to see whether they provide this type of service.

You may pay a monthly fee for chronic care management services. Yet you may be able to cover the monthly fee through Medicaid or supplemental insurance, such as Medicare Part C. The Part B coinsurance and deductible still apply.

Medicare doesn’t cover certain services, even if they’re needed to diagnose, treat, or manage heart disease.

These include:

How often does Medicare pay for an echocardiogram or electrocardiogram (EKG)?

An echocardiogram uses ultrasound to detect irregularities in the heart’s structure. An electrocardiogram (EKG or ECG) uses electrodes to detect irregularities in the heart’s electrical signals.

Medicare Part A covers these tests during a hospital stay, while Part B covers the test in an outpatient clinic. Both parts require a doctor’s order and must be medically necessary.

Medicare Advantage (Part C) also covers this test with in-network professionals, while Medigap supplements can help pay for the cost of the test under Original Medicare.

What’s included in a cardiovascular screening?

During a routine checkup, your doctor will assess your body mass index (BMI), blood pressure, pulse rate, and oxygen saturation level. They will also listen to your heart for any signs of arrhythmia, valve disease, or other cardiac conditions. To get an accurate picture of your heart health, they may order various blood tests and, in some cases, a test like EKG.

Does Medicare cover cardiologist visits?

A cardiologist is a specialist who diagnoses heart disease. Medicare should pay for a visit if it is deemed medically necessary. This may mean that your primary care doctor must refer you based on screening results.

Medicare covers many tests used to diagnose heart disease. It also covers cardiac rehabilitation programs and cardiovascular behavioral therapy if you have a qualifying health condition.

If necessary, Medicare will cover chronic care management services as well.

Medicare doesn’t cover 100% of all costs, though. Talk with your doctor about your needs and expected out-of-pocket payments, including the cost of medications.

You may be able to reduce out-of-pocket costs with additional insurance available from Medigap, Medicare Advantage (Part C), and Part D.