Your Medicare Coverage

Is my test, item, or service covered?

Cardiac rehabilitation programs

How often is it covered?

Medicare Part B (Medical Insurance) covers comprehensive programs that include exercise, education, and counseling. Part B also covers intensive cardiac rehabilitation (ICR) programs that, like regular cardiac rehabilitation (CR) programs, include exercise, education, and counseling. ICR programs are typically more rigorous or more intense that CR programs. These programs may be provided in a hospital outpatient setting (including a critical access hospital) or in a doctor's office.

Who's eligible?

People with Part B are covered. You must be referred by your doctor and have had any of these:

  • A heart attack in the last 12 months
  • Coronary artery bypass surgery
  • Current stable angina pectoris  
  • A heart valve repair or replacement
  • A coronary angioplasty or coronary stent  
  • A heart or heart-lung transplant
  • Stable chronic heart failure

Intensive Cardiac Rehabilitation (ICR) programs are also covered when referred by a doctor.

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount if you get the services in a doctor's office. In a hospital outpatient setting, you pay the hospital a copayment. The Part B deductible applies.

Note

To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

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