Did you know that 17% of adults ages 65+ have reported having heart disease? Aso known as cardiovascular disease, heart disease is a broad term used to describe a range of conditions that affect your heart. It’s no secret that managing heart disease can be costly; from medications to surgeries and regular check-ups, the financial burden can be heavy. Thankfully, Medicare Advantage health insurance for heart patients can help ease this burden — but not all plans are created equal. 

To help you better navigate your options, this blog post will take a deeper look into the best type of health insurance for Medicare beneficiaries who have heart disease, as well as explain how you can take advantage of Rest of Year enrollment to best manage your health.

Understanding Medicare Plan Types

Before we dive into the specifics, it’s essential to understand the basics of Medicare. Medicare is a federal program that provides health coverage if you are 65 or older or have certain disability benefits. It’s divided into four parts: Part A (Hospital Insurance), Part B (Medical Insurance), Part D (Prescription Drug Coverage), and Part C (Medicare Advantage Plans).

  • Part A and Part B: Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care, whereas Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Together, Part A and Part B form what’s commonly referred to as “Original Medicare.”
  • Part D: Part D adds prescription drug coverage to Original Medicare. It helps cover the cost of prescription medications, including many of the drugs used to treat heart disease.
  • Part C (Medicare Advantage): Medicare Advantage Plans are an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Most offer extra benefits such as vision, hearing, dental, and more.

The Best Health Insurance for Heart Patients

After understanding the basics of Medicare, the question still remains: which is the best Medicare health insurance for heart patients? The answer largely depends on individual needs and circumstances, but generally, a Medicare Advantage Plan (Part C) can be highly beneficial.

Why Medicare Advantage?

We recommend Medicare Advantage plans to our patients at Meadowcrest because, simply put, these plans often provide more coverage than Original Medicare. For example, most Medicare Advantage plans include prescription drug coverage, and this benefit alone can be incredibly helpful for individuals with heart disease who may have a need to fill several medications.

Additionally, these plans often include extra benefits like routine vision and dental care, wellness programs, and gym memberships. These additional perks can help individuals with heart disease manage their condition and prevent complications.

Another advantage of Medicare Advantage plans is the out-of-pocket maximum. In contrast to Original Medicare, which does not have an out-of-pocket limit, Medicare Advantage plans cap your out-of-pocket expenses. Once you reach this limit, you won’t have to pay for covered services for the rest of the year. This financial protection can be especially crucial for individuals with heart disease who often have high medical costs.

Choosing the Right Plan

When choosing a Medicare Advantage plan, consider the following factors:

  • Coverage: Ensure that the plan covers the services you need. These might include specialist visits, cardiac rehabilitation, and heart disease medications.
  • Cost: Look at the plan’s premiums, deductibles, and out-of-pocket maximums. Also, consider the costs for services and medications you’ll likely use.
  • Provider network: Check whether your doctors and hospitals are in the plan’s network. Out-of-network care can be more expensive.
  • Quality ratings: Medicare rates all Medicare Advantage plans based on the quality of care and customer service. Choose a plan with high ratings to ensure you’re getting the best care possible.

Rest of Year (ROY) Enrollment: Special Needs Plans for Heart Disease Patients

For someone with heart disease, managing the condition can be a complex process that requires specialized care and attention. Recognizing this, Medicare offers a type of Medicare Advantage plan called a Special Needs Plan (SNP), which is specifically designed for people with certain diseases or characteristics, including chronic heart conditions.

To qualify for a Chronic Condition Special Needs Plan (C-SNP) for heart disease, you need to have a doctor’s diagnosis of your heart condition. Once you’re eligible, the SNP provides all the benefits of Medicare Advantage, along with additional services tailored to your specific needs. For example, your SNP may offer a broader range of heart disease medications in its formulary, or it might cover cardiac rehabilitation programs. You can also enroll in a SNP at any time of the year.

Enrolling in an SNP also means you’ll have a care coordinator who can help manage your healthcare providers and services. This is especially beneficial for heart disease patients who often see multiple specialists.

It’s important to note that the availability of these plans can change from year to year, so it’s always a good idea to check with Medicare or a trusted insurance advisor to see if there’s an SNP that fits your needs in your area. 

Our trusted representative will happily help you navigate finding health insurance for heart patients and answer Medicare-related questions. Contact us today to learn more and schedule an appointment.

Remember, having heart disease doesn’t mean you can’t lead a healthy, fulfilling life. With the right Medicare coverage and a great team of doctors, you can manage your condition effectively and continue living life to the fullest!