Cardiovascular disease generally refers to conditions that can lead to heart attack or stroke. Cardiovascular disease risk reduction visits can help detect and prevent this disease.
Medicare Part B covers an annual cardiovascular disease risk reduction visit with your primary care provider (PCP). You do not need to show signs or symptoms of cardiovascular disease to qualify for screening, but you must be considered competent and alert when counseling is provided. During the screening, your PCP may:
- Encourage aspirin use if the benefits outweigh the risks and:
- You are a man age 45-79
- Or, you are a woman age 55-79
- Screen for high blood pressure if you are age 18+
- Provide behavioral counseling and tips to encourage a healthy diet
Note: Men under 45 and women under 55 are not encouraged to use aspirin as a tool to reduce cardiovascular disease.
If you qualify, Original Medicare covers cardiovascular disease risk reduction visits at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover cardiovascular disease risk reduction visits without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.
During the course of your cardiovascular risk reduction visit, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.
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