Does Medicare Cover Atrial Fibrillation Treatments?

September is National Atrial Fibrillation Awareness Month. Atrial Fibrillation, also known as AFib, is a major health concern in the United States, affecting 2.3 million Americans. It is also the most common form of arrhythmia in patients over 65; in fact, around 70% of people with atrial fibrillation are between the ages of 65 and 85 years old. If you are an older adult with this condition, you are at significantly higher risk of having a stroke, so it is important to receive the proper treatment – but are these treatments covered under Medicare? 

illustration of a heart with a red circle around it
With AFib, the heart will beat irregularly due to a change in the blood flow.

What Is Atrial Fibrillation?

Your heart has four chambers: two upper chambers called atria, and two lower chambers called ventricles. In a healthy heart, the atria beat regularly, helping blood flow to the ventricles, but if you suffer from atrial fibrillation, your atria beat irregularly, changing the blood flow, making it either too fast or too slow. If AFib is not controlled, it can lead to severe complications such as stroke, blood clots, and even death; in fact, patients with the disease are twice as likely to die as patients without AFib. 

Risk Factors

There are a number of factors that increase your risk of atrial fibrillation, including:

  • Older age 
  • Gender – Men are 1.5 times more likely to develop AFib
  • Obesity – Obese patients have a 1.5 to 2.3 times greater risk of developing AFib, and of having the condition progress to permanent AFib
  • Sleep apnea
  • Diabetes 
  • High blood pressure

Common Symptoms

illustration of a woman who is dizzy
Dizziness is a common symptom of AFib.

A person with atrial fibrillation might have no symptoms, or they might experience mild symptoms. If symptoms do occur, they can include:

  • Heart palpitations
  • Dizziness
  • Chest pain
  • Shortness of breath
  • Lightheadedness 
  • Low blood pressure
  • Extreme tiredness
  • Weakness

Medicare Coverage & Costs

Medicare covers various treatments for AFib, as long as the treatment is deemed medically necessary by your doctor. Part A will generally cover:

  • Hospital or skilled nursing facility stays brought on by your AFib
  • Pacemaker placement
  • Catheter and surgical ablation
  • Electrical cardioversion- This is a low-voltage shock that helps to regulate your heartbeat
  • Chemical cardioversion- This type of treatment involves getting medications through an IV in a hospital setting

Medicare Part B will cover any outpatient services, including doctor visits, screenings, and diagnostic exams; Part B will also cover cardiovascular disease screening every 5 years, as well as  cardiac rehabilitation programs. As with any medically necessary services, Medicare Part B will only cover up to 80% of the expenses, leaving you to pay the remaining 20%, as well as your Part B deductible, out-of-pocket.

Saving Money 

Atrial fibrillation can be a costly condition to manage because it often requires ongoing treatment and medication; in fact, according to the Center for Medicaid and Medicare Services (CMS), the management of the condition and its complications costs the U.S. healthcare system roughly $26 billion dollars each year! For individuals managing the condition, costs can add up fairly quickly, especially since Medicare Part B does not cover everything.pink piggy bank with coins stacked in front of it If you have a lot of medical expenses because of a condition like AFib, a Medicare Supplement Plan can help save you a lot of money. Most of these plans will cover many of the out-of-pocket expenses that Medicare does not, like copays and coinsurance, or even for medical care while you’re traveling. In most states, you have the choice of 10 different Medicare Supplement Plans with different levels of coverage and price points, so you’re sure to find a plan that is right for you.

If you need help finding the right Medicare Supplement Plan for you, EZ can help, because our agents work with the top-rated insurance companies in the country. You will be paired with your own agent who will compare all available plans in your area to help find a plan that meets your financial and medical needs. All of our services come at no cost to you, and there is no obligation and no hassle. To get free instant quotes, simply enter your zip code in the bar above, or to speak to one of our license agents, call 888-753-7207.

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