Heart health is an area of growing concern, especially as the American population experiences longer life expectancies. The human heart is a fairly simple design that utilizes valves and tubes to move blood through the body, allowing organs, muscles and other tissue to receive nutrients, vitamins and a host of other energy-producing substances. Unfortunately, cholesterol can cause this blood flow to be interrupted or stopped altogether, sometimes leading to a heart attack or stroke.
To alleviate these concerns, medical professionals have recommended dietary changes and daily exercise, but some patients require surgery to repair blocked arteries. Heart bypass surgery is a coronary procedure that involves literally bypassing a blocked artery to restore blood flow. In some cases, this procedure is planned in advance, but in many others, it is undertaken as an emergency measure. In severe cases, bypass surgery is completed numerous times in the same session. This is usually referred to as a double, triple or quadruple bypass surgery.
Does Medicare Cover Heart Bypass Surgery?
A heart bypass surgery can easily cost over $100,000, meaning patients usually require some type of insurance in order to pay for the procedure. This is especially important because of the aforementioned unpredictable nature of needing a heart bypass surgery. Medicare, thankfully, does cover heart bypass surgery in virtually all cases as the procedure is considered a medical necessity.
Coverage is centered around Medicare benefits as outlined in Part A and Part B. Part B of Medicare provides coverage for outpatient procedures, including surgery, while Part A covers hospital care once you are formally admitted.
Part D of Medicare benefits covers prescription drugs, so if any medications are required during, before, or after a patient receives a heart bypass operation, Part D would apply. This typically only covers drugs that are available for purchase from a retail pharmacy for home use. Drugs that are administered during surgery or while in a hospital would once again be covered under Medicare Part A or Part B depending on where they are administered.
Medicare Coverage of Heart Bypass Surgery
It’s important to keep in mind that there are still some expenses that Medicare recipients may be expected to cover on their own when heart bypass surgery is required. First, a deductible applies to all Medicare plans unless you have a Medicare Advantage plan that provides additional coverage.
Medicare’s coverage of your hospital stay takes into account all of the time you’ve spent hospitalized or in a skilled nursing facility for the current benefit period. Usually, program benefits for Medicare recipients are limited to a total of 60 days within a period, so if you have already spent time hospitalized, that time will count toward your total. Time spent hospitalized beyond 60 total days may be billed directly to the patient unless they have supplemental insurance.
Consider Lifestyle Changes
Although surgery may be an option to extend your life and protect your heart, it’s always a good idea to work with your physician to develop a heart wellness plan. As mentioned, making changes to your diet to limit things like cholesterol can help to reduce the risk of developing heart disease, but you need to discuss these changes with your doctor as he or she knows your individual needs. Some medications require a specific diet in order to work effectively, so don’t make any sudden or drastic dietary changes without prior approval.
Additionally, ensuring that you remain active can play a major role in reducing the risk of developing heart disease, but again, your doctor needs to be aware of changes to your daily activity level. Some patients may require a modified exercise plan, especially with age, in order to avoid doing more harm than good.
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