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Cardiovascular Disease Risk Reduction

Cardiovascular disease generally refers to conditions that can lead to a heart attack or stroke. Cardiovascular disease risk reduction visits can help detect and prevent this disease.

How to know if I am Eligible?

Medicare Part B covers an annual cardiovascular disease risk reduction visit with your primary care provider. You do not need to show any signs or symptoms of cardiovascular disease to qualify for screening, but you must be considered competent and alert when counseling is provided. 

During the screening, your provider may;

  • Encourage aspirin use if the benefits outweigh the risks
  • You are a man  of age 45-79
  • Or a woman of age 55-79
  • Screen for high blood pressure if you are age 18+
  • Provide behavioral counseling and tips to encourage a healthy diet

Note: Men under 45 and women under 55 are not encouraged to use aspirin as a tool to reduce cardiovascular disease.

How much will it cost?

If you are eligible, Original Medicare will cover your cardiovascular disease risk reduction visits at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means that you don't have to pay anything for the said service.

In Medicare Advantage Plans,  they are required to cover cardiovascular disease risk reduction visits 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 visit, your provider may discover and need to investigate or treat a new or existing problem. This additional care is now considered diagnostic. Your provider will be treating you because of certain symptoms or risk factors. This time, Medicare may bill you for any diagnostic care you receive during a preventive visit.

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