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Does Medicare Cover Cardiac Rehabilitation for Heart Attack Survivors?

Medicare may cover cardiac rehabilitation if you experience a heart attack or other heart problems.

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Every year, over 800,000 people in the US have heart attacks – one every 40 seconds! Fortunately, a high percentage of people (97% - 98% ) survive heart attacks that do not result in cardiac arrest. So, what’s the difference between heart attack and cardiac arrest?

What is a Heart Attack?

A heart attack results from a blockage of blood flow to the heart . Plaque buildup inside the walls of the coronary arteries (atherosclerosis ) can cause arteries to narrow and block blood flow. When plaque breaks, a blood clot can form and cause a heart attack .

Heart attacks require immediate medical assistance. So, during this medical emergency call 911 right away!

What is a Cardiac Arrest?

Cardiac arrest is the sudden loss of all heart activity . The person stops breathing and becomes unconscious. In other words, the person has collapsed and has no pulse.

If a person is not breathing and has no pulse, immediately begin cardiopulmonary resuscitation (CPR). If you have access to a portable automated external defibrillator (AED), you can use this device to shock the person’s heart and get it beating again. Otherwise, continue CPR until medical emergency teams arrive.

Medicare Coverage for Cardiac Rehabilitation

Medicare Part B covers cardiac rehabilitation programs if you have any of the following conditions:

  • A heart attack in the last 12 months

  • Coronary artery bypass surgery

  • Current stable angina (chest pain)

  • Heart valve repair or replacement

  • Coronary angioplasty (medical procedure to open a blocked artery) or coronary stent (procedure used to keep an artery open)

  • Heart or heart-lung transplant

  • Stable chronic heart failure

Medicare covers regular or intensive cardiac rehabilitation programs in a doctor’s office or hospital outpatient setting. After you pay the Part B deductible, Medicare pays 80% of the Medicare-approved amount for these services. In a hospital outpatient setting, you may also pay a hospital copayment.

What is Cardiac Rehabilitation?

Cardiac rehabilitation is a medically supervised program to improve your cardiovascular health. The program includes :

  • Physical activity

  • Education about healthy living (how to eat healthy, take medicine as prescribed, and quit smoking)

  • Counseling to find ways to relieve stress and improve mental health

Studies have shown that cardiac rehabilitation increases the 5-year heart attack survival rate by about 35% .

Get answers to your Medicare coverage questions, call 1-833-463-3262 to speak with a licensed agent.

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