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Medicare pays for many preventive services in order to aid you in staying healthy. Preventive services can find problems early and can help keep you from getting certain diseases or illnesses. These services include exams, lab tests, and screenings. One of these services is cardiovascular screening.
What is Cardiovascular Screening?
Cardiovascular screening is a set of blood tests that checks cholesterol and other blood fat levels. The cardiovascular screening benefit helps you learn if you have an increased risk of heart disease, and how to control cholesterol levels through diet, physical activity, or if necessary, medication. This screening is frequently done in conjunction with a routine physical exam.
This screening should be done when a person is healthy. Blood cholesterol is temporarily low during illness, immediately following a heart attack, or during stress (such as surgery or an accident). You should wait at least six weeks after any illness to have your cholesterol measured. Some drugs (anabolic steroids, beta-blockers, epinephrine, oral contraceptives, and vitamin D) may also affect your cholesterol levels. Make sure you inform your doctor about any issues that may affect your screening results.
What is Cholesterol?
Cholesterol is a fat-like waxy substance that occurs naturally in all parts of the body. Every body needs some cholesterol to work properly. But if there is too much in your blood, it can stick to the walls of your arteries. This is known as plaque. Plaque can narrow or even block arteries.
High levels of cholesterol in the blood can increase the risk of cardiovascular disease. Cholesterol levels tend to rise as you get older. There are usually no signs or symptoms to indicate high blood cholesterol, but it can be detected with a blood test.
What is Cardiovascular Disease?
Cardiovascular disease is a term used to describe many diseases that affect the heart or blood vessels. Some of the diseases that fall under the term cardiovascular disease include coronary artery disease, heart attack, heart failure, high blood pressure and stroke.
Cardiovascular disease is often called heart disease because both terms refer to diseases of the heart or arteries. Cardiovascular disease is the number one leading cause of death for both men and women, even in the United States. Many types of cardiovascular disease are often related to preventable risk factors. Cardiovascular screening can let you know if you are at risk for cardiovascular disease.
Does Medicare Cover Cardiovascular Screening?
Medicare covers cardiovascular screenings that check cholesterol and other blood fat (lipid) levels. High levels of cholesterol can increase the risk for heart disease and stroke. These screenings will tell if you have high cholesterol. Medicare covers the following tests:
- Total cholesterol
- High density lipoproteins (lipid test)
- Triglycerides levels
Your physician must order cardiovascular screening blood tests for the purpose of early detection of cardiovascular disease.
Do I Qualify for a Cardiovascular Screening?
All people with Medicare qualify for this screening. If you have not been previously diagnosed with cardiovascular disease, you may receive cardiovascular screening blood tests every five years to assess for risk factors. It is not necessary to test more frequently, since lipid and cholesterol levels often remain fairly consistent.
However, cholesterol testing may be ordered more frequently for those who have one or more risk factors for heart disease. Major risk factors include:
- Cigarette smoking
- Age (men 45 years or older or women 55 years or older)
- Hypertension (blood pressure of 140/90 or higher or taking high blood pressure medications)
- Family history of premature heart disease (heart disease in an immediate family member—male relative under age 55 or female relative under age 65)
- Pre-existing heart disease or already having had a heart attack
- Diabetes mellitus
What Do I Pay for Cardiovascular Screening?
If you have Original Medicare and your doctor or health care provider accepts assignment, you will pay nothing for the cardiovascular screening. There is no deductible or copayment for this benefit.
If you receive your Medicare through a Medicare Advantage Health Plan, you may owe little to nothing depending on the plan you are signed up with and your benefits with the plan. If your doctor recommends that you have this test more often than Medicare covers them, you may have to pay for these additional services.