Medicare coverage for cardiac rehabilitation

Published by Medicare Made Clear®


Hearing a doctor say “you have heart failure” can be frightening. The words sound so final. But heart failure doesn’t mean that the heart has stopped working. And Medicare does provide some coverage for helping with heart health including cardiac rehabilitation.

Cardiac rehabilitation may help with heart failure

Heart failure is a chronic condition that many people live with and manage. It’s sometimes called congestive heart failure, or CHF. It is caused by other diseases that damage the heart muscle. Diseases and conditions that may cause heart failure include heart disease, high blood pressure and diabetes.

Cardiac rehabilitation (rehab) is a medically supervised program for people with heart conditions. The purpose is to help improve health and well-being and to help the individual live an active life.

Cardiac rehab programs focus on teaching heart-healthy behaviors such as:

  • Eating a low-fat, low-salt diet
  • Including regular, safe physical activity
  • Reducing stress

Medicare Part B will cover cardiac rehabilitation, which can help with heart failure.

Medicare covers cardiac rehab for heart failure

Medicare Part B covers cardiac rehab for people with stable heart failure who meet certain standards and are referred by a doctor. The individual pays 20% of the Medicare-approved amount when the service is through a doctor’s office or the hospital co-payment when it’s in a hospital outpatient setting. The Part B deductible applies.

People with heart failure who don’t qualify for cardiac rehab may still get help. Lifestyle recommendations are usually part of the treatment plan. This may include a process of steadily increasing physical activity to help keep heart failure from worsening.

Many Medicare Advantage (Part C) plans offer gym memberships that could help support a heart-healthy lifestyle. People with heart failure may also want to look into a Special Needs Plan. These plans are designed specifically for those with chronic health conditions.

Conclusion

There is no cure for heart failure, but it’s possible to treat it and live a normal, active life. A cardiac rehab program may help.

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