Heart disease, also known as cardiovascular disease, generally refers to conditions that can lead to heart attack or stroke. Screening blood tests for cholesterol, lipid, and triglyceride levels can detect conditions that may lead to heart disease.
Medicare Part B covers blood tests for heart disease once every five years, when ordered by your provider. You do not need to show signs of heart disease or have any particular risk factors to qualify for these tests.
If you qualify, Original Medicare covers screening blood tests for heart disease 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 heart disease screenings 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 heart disease screening, 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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