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Cardiovascular risk assessment & management services

Medicare Part B (Medical Insurance) may cover a cardiovascular risk assessment if you’re eligible

  • Covered by Part B
  • After the Part B deductible , you pay 20% of the Medicare-approved amount

Description

A cardiovascular risk assessment calculates your risk level using:

  • Demographic data (like age and sex)
  • Routine measurements (like blood pressure and weight)
  • Smoking history and alcohol use
  • Physical activity levels
  • Laboratory data (like lipid panels to check your cholesterol levels)

Coverage details

As part of your risk assessment, you’ll get a 10-year estimate of your risk for developing cardiovascular disease. For people at intermediate, medium, or high risk, Part B may also cover risk management services. These services might help lower your risk of cardiovascular disease and may include:

  • Blood pressure management
  • Cholesterol management
  • Help to stop smoking

Who's eligible

If you haven’t been diagnosed with cardiovascular disease and your doctor or other health care provider determines you’re at risk for developing the disease.

Costs

After the Part B deductible , you pay 20% of the Medicare-approved amount.

Ask your doctor or healthcare provider how much your test, item, or service will cost.

Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.

Specific amounts you could owe depend on:

  • Other insurance you may have

  • How much your doctor charges

  • If your doctor accepts assignment

  • The type of facility

  • Where you get your test, item, or service