Does Medicare cover cardiac rehab?

Health insurance coverage can be confusing, especially for people who are on Medicare. If you have recently been dealing with heart issues, you may be asking does Medicare cover cardiac rehab? The answer is yes, but it depends on your condition and doctor’s recommendation as well.

Cardiac rehab programs are covered under Medicare Part B. If you are only enrolled in Medicare Part A, which is hospital insurance, Medicare will not cover the costs of your cardiac rehab program. It is important to understand what type of Medicare coverage you have, and what it will cover in the event you need to use it.

We’re going to look into the specifics of Medicare cardiac rehab so that you can move forward with confidence in understanding what your health insurance covers and what it does not.

If you’re ready to compare health insurance rates for Medicare plans in your area, enter your ZIP code above.

Is my cardiac rehab covered by Medicare?

Yes, Medicare Part B covers cardiac rehab. However, Medicare will only cover cardiac rehab if you have a specific condition.

According to Medicare.gov the following are conditions that qualify for Medicare coverage of cardiac rehab:

• heart attack (in the last 12 months)
• coronary artery bypass surgery
• current stable angina (chest pains)
• heart valve repair
• heart valve replacement
• coronary angioplasty
• coronary stent
• heart transplant
• lung transplant
• stable chronic heart failure

If you don’t currently have one of the above conditions Medicare will likely not cover the costs of your cardiac rehab.

How much will cardiac rehab cost me?

Even with Medicare Part B coverage, you will still have to pay a copayment and or a deductible. Understanding health care deductibles and costs is important for budgeting purposes.

Take a look at the average costs of Medicare Part B.

The amount of money you owe for your cardiac rehab will largely depend on where you go for your rehab. If you’re receiving your rehab treatment in a doctor’s office you will pay 20% of the Medicare-approved amount. Part A benefits cover 100 days in a skilled nursing facility, although coinsurance costs apply.

If you are going to a hospital for your cardiac rehab, you will pay the hospital copayment amount. Your Medicare Part B deductible will apply as well. One important term to understand with your Medicare coverage is the “benefit period.” Coverage is normally reviewed based on each benefit period.

Does Medicare cover intensive cardiac rehab programs (ICR)?

If your doctor refers you to intensive cardiac rehab, Medicare Part B will cover this program too. ICR programs often involve more rigorous physical activity, physical therapy, counseling, and education services. These intensive programs are often done in a hospital outpatient setting or in a doctor’s office.

Does Medicare cover cardiac rehab? Yes, but you need to qualify for coverage by having one of the conditions that Medicare will cover. Speak with your doctor and with your Medicare representative to get a complete understanding of what is and isn’t covered under your Medicare Part B plan.

If you’re ready to buy Medicare Part B coverage or a supplemental Medicare health insurance policy, enter your ZIP code below to start comparing rates near you.