Medicare Coverage: Cardiac Rehabilitation
When you or a loved one on Medicare are recovering from a heart attack, it is good to know that Medicare coverage pays for programs for cardiac rehabilitation – from regular to intensive care. Beneficiaries who meet specific conditions, may see any health care provider who accepts Medicare for counseling, education or exercises that will help them recover. If you receive the services at your doctor’s office, you are responsible for your share of the Medicare-approved amount (20%).
Medicare Part B will pay 80% of the Medicare-approved amount for your cardiac rehabilitation. As long as you have to stay in a hospital, the hospital co-payment also applies. If you have additional Medicare health insurance such as Medicare advantage, your plan may also include additional benefits and reduce your deductible. To find out whether your Medicare advantage plan provides additional coverage or whether you need to co-pay for your cardiac rehabilitation, you need to contact your plan provider.
If you had a heart attack within the last year, coronary bypass surgery, coronary stenting, a heart valve replacement, or similar medical procedures, Medicare will be helping you with your rehabilitation as long as you fulfill two requirements:
- The rehabilitation program needs to be deemed ‘medically necessary’ by Medicare: it must be prescribed by a licensed health care provider and be approved by Medicare (or your Medicare advantage plan)
- The health care must be provided by a facility or provider that accepts Medicare
The same applies to any medication necessary for your recovery.
