Women and Heart Disease: Medicare Publication 11294

Who Should Read This

This publication is written for women who are 65 or older and currently enrolled in Medicare, as well as women approaching age 65 who are getting ready to enroll. It is especially relevant for women who have a family history of heart disease, high cholesterol, high blood pressure, or diabetes — all conditions that raise the risk of heart problems. Women who smoke or who have been told by a doctor to watch their cardiovascular health will also find this information valuable.

Adult children, spouses, and other caregivers who help an older woman manage her health decisions should read this as well. Understanding what Medicare covers makes it easier to encourage loved ones to take advantage of free or low-cost preventive services before a serious heart event occurs.

Quick Overview

This publication from the Centers for Medicare & Medicaid Services (CMS) explains the preventive services that Medicare covers to help women reduce their risk of heart disease. It points readers to key services — from wellness visits and cardiovascular screenings to diabetes support and smoking cessation — and directs them to tools for finding and comparing providers. The publication is a brief two-page reference guide designed for quick reading.

Key Takeaways

• Medicare covers a yearly "Wellness" visit and a one-time "Welcome to Medicare" preventive visit that can both be used to discuss heart disease risk with a doctor.
• Cardiovascular screenings, behavioral therapy, and cardiac rehabilitation programs are covered by Medicare to help prevent and manage heart disease.
• Diabetes and heart disease are closely linked — Medicare covers diabetes screenings, prevention programs, self-management training, and nutrition therapy.
• Help with quitting smoking is a covered benefit, since smoking is one of the leading risk factors for heart disease in women.
• Medicare Part D drug plans can cover prescription medications used to manage heart-related conditions.
• Criteria must be met for some services, and coinsurance or deductibles may apply depending on the specific service and how it is received.
• Women can log into their Medicare account at Medicare.gov to view a personalized list of preventive services they are eligible for and print a report to bring to their next appointment.

Publication Summary

Heart disease is the leading cause of death for women in the United States, yet many women do not realize how much Medicare can do to help them stay ahead of it. This CMS publication serves as a straightforward guide to the preventive services Medicare covers that are directly related to heart health.

Preventive Visits

The publication highlights two important visits that every Medicare beneficiary should know about. The first is the "Welcome to Medicare" preventive visit, which is available within the first 12 months of enrolling in Medicare Part B. This visit gives women the chance to sit down with their provider, talk about their personal health history, and get a referral for screenings that may be appropriate for them. The second is the yearly "Wellness" visit, which is an annual check-in that can be used to update a personalized prevention plan and review risk factors for heart disease. Both visits are important opportunities for women to have an open conversation with their doctor about cardiovascular health.

Cardiovascular Screenings and Therapy

Medicare covers cardiovascular screenings, which include blood tests that check cholesterol, lipid, and triglyceride levels. These tests can detect warning signs for heart attack or stroke before symptoms appear. Medicare also covers cardiovascular behavioral therapy — a visit focused on helping patients lower their heart disease risk through lifestyle guidance such as blood pressure monitoring and heart-healthy eating. For women who have already been diagnosed with a qualifying heart condition, Medicare covers cardiac rehabilitation programs that combine exercise, counseling, and education to support recovery and ongoing management.

Diabetes-Related Coverage

The connection between diabetes and heart disease is well established. Women with diabetes face a significantly higher risk of developing heart problems. The publication outlines several diabetes-related services that Medicare covers, including diabetes screenings to identify the condition early, access to Medicare's Diabetes Prevention Program for those at risk, diabetes self-management training for those already diagnosed, and Medical Nutrition Therapy — a program delivered by a registered dietitian to help manage blood sugar through diet. These services work together to address a major driver of heart disease in women.

Smoking Cessation

Smoking dramatically raises the risk of heart disease, and Medicare covers help with quitting. This benefit is an important resource for women who smoke and are looking for support, whether through counseling sessions or other cessation services. The publication reminds readers that quitting smoking is one of the most impactful steps a woman can take to protect her heart.

Prescription Drug Coverage

While Medicare's original coverage (Parts A and B) does not cover prescription drugs on its own, the publication notes that Medicare drug coverage through Part D can cover medications used to prevent or treat heart-related conditions. Women who rely on medications for cholesterol, blood pressure, or blood thinning should make sure they have adequate drug coverage as part of their overall Medicare plan.

Tools and Resources

The publication directs women to log into their Medicare account at Medicare.gov to review a personalized list of eligible preventive services. Users can also find and compare providers in their area using Medicare's Care Compare tool. For those without internet access, the 1-800-MEDICARE helpline (1-800-633-4227) is available, with TTY access at 1-877-486-2048.

Frequently Asked Questions

Does Medicare cover heart disease screenings for women with no symptoms? Yes. Medicare covers cardiovascular screening blood tests — including cholesterol, lipid, and triglyceride tests — once every five years. Women do not need to show symptoms or have known risk factors to qualify for these tests.

What is the difference between the "Welcome to Medicare" visit and the yearly Wellness visit? The "Welcome to Medicare" visit is a one-time preventive visit available within the first 12 months of enrolling in Part B. The yearly Wellness visit is an annual benefit that can be used each year going forward. Both visits are opportunities to discuss heart disease risk and set up a prevention plan with a doctor.

Does Medicare help with quitting smoking? Yes. Medicare covers smoking cessation counseling, which is directly relevant to heart health since smoking is a major risk factor for cardiovascular disease in women.

What diabetes services does Medicare cover that are related to heart health? Medicare covers diabetes screenings, the Diabetes Prevention Program, diabetes self-management training, and Medical Nutrition Therapy. Since diabetes significantly raises the risk of heart disease, these services are an important part of protecting heart health.

How can a Medicare beneficiary find out which preventive services she is eligible for? Women can log into their secure Medicare account at Medicare.gov, navigate to "My preventive services," and view a personalized list. They can also print a report under "Download my data" to bring to a doctor's appointment, or call 1-800-MEDICARE for assistance.

Access the Full Publication

CMS Product No.: 11294 
Publication Date: May 2024 
Length: 2 pages