Cardiac rehabilitation programs are designed for patients with heart conditions or a recent heart surgery. These programs provide services that allow these patients to receive help with exercise, counseling, and education about their condition. Through these programs, individuals can improve their heart health and reduce risk factors to prevent current heart issues from worsening or new ones from occurring. Medicare recipients can receive coverage for cardiac rehab programs through Medicare Part B plans as long as they meet the required criteria.
What is Cardiac Rehabilitation?
There are two types of cardiac rehab programs: general cardiac rehab and intensive cardiac rehab. Each of these programs often takes place in a hospital setting and is carried out by either a specialized rehab team or by your doctor and other healthcare providers.
Cardiac rehab is most often prescribed for patients who have suffered a heart attack, are currently diagnosed with a heart condition, like heart failure or coronary artery disease, or have undergone a surgical procedure, such as a coronary artery bypass graft, stent placement, pacemaker insertion, or valve replacement.
When a person has a heart condition or is recovering from surgery, making proper lifestyle choices is critical to ensure that the current condition is properly managed, the surgical procedure is effective, and new issues do not arise in the future. Cardiac rehab programs provide help with lifestyle choices and allow patients to be in a controlled environment so that they can get clarification on any questions they have.
Cardiac rehab programs often consist of a few different components. First, your medical team with work with you to establish your current needs and your limitations. This information can then be used to tailor a rehab program to your specific requirements.
Exercise is often a major component of these programs. Exercise is critical to maintaining a healthy heart and body, and many patients are scared to begin exercising following a heart issue, especially a surgery. Cardiac rehab allows patients to begin exercising in a controlled environment where they are monitored.
Over time, the rehab team will progress the person’s exercises and workout intensity to challenge them. These services help patients introduce exercise into their lives, increase their comfort level, and allow them to become familiar with the type and duration of exercises they should be performing to optimize their health.
In addition to exercise, cardiac rehab also places a major emphasis on education and counseling regarding both a patient’s condition and the impact of their lifestyle choices. Education points can include dietary advice, the importance of eliminating smoking and limiting alcohol consumption, stress-reducing mechanisms, and much more. Counseling services are also available to help patients change current behaviors or better deal with their conditions.
Do Medicare Benefits Cover Cardiac Rehab?
Medicare recipients are entitled to cardiac rehab services as long as they meet the required criteria. Patients are eligible if they have had a heart attack in the past 12 months, underwent a bypass surgery, had a valve repair or replacement, had a coronary stent placed, required a heart transplant, suffer from stable chronic heart failure, or have stable chest pain.
For general cardiac rehab, Medicare will cover up to two one-hour sessions per day and a total of 36 sessions. If deemed medically necessary, Medicare may cover an additional 36 sessions. For intensive cardiac rehab, patients are eligible to receive coverage for up to six one-hour sessions per day and a total of 72 sessions; however, these sessions must be completed over an 18-week period.
Medicare Part B will provide coverage for a rehabilitation program, regardless of whether you qualify for general rehab or intensive rehab. As far as cost is concerned, Medicare benefits will pay for 80 percent of the Medicare-approved amount of the service. This leaves you to pay your Part B premium payment, your deductible amount, which was $185 for 2019, potentially a copayment depending on where you rehab takes place, and a coinsurance payment of 20 percent of the Medicare-approved amount of the program.