After a cardiac medical episode, patients will often need to undergo rehabilitation to not only strengthen the body and monitor the progress of any medical procedures that have been undertaken, but also to promote healthy living in the future. In many cases, the rehabilitation process is carried out in phases. Programs are designed this way to allow doctors and patients to work at their own pace as a team as each situation is different and will require unique care as time goes by.
What Are the Phases of Cardiac Rehab?
The first phase of the cardiac rehabilitation process begins right after a cardiac episode or medical procedure. Many times, patients will still be hospitalized when phase one begins, and this phase includes patient education regarding risk factors, dietary and lifestyle change suggestions and a detailed explanation of what options are available to treat current symptoms. Phase one rehabilitation for patients who have undergone open heart surgery may also incorporate working with a physical therapist.
In the second phase, the patient will continue to seek medical care on an outpatient basis from his or her physician and cardiac team. During this phase, many patients are required to wear monitoring technology to measure progress and check for any warning signs of potential danger.
During phase three, a comprehensive wellness plan is formed that is meant to guide the patient in making heart-healthy lifestyle choices going forward. Many people in phase three cardiac rehab will attend education classes and exercise programs that are centered around protecting and strengthening the heart.
Does Medicare Cover Phase Three Cardiac Rehab?
Medicare provides coverage for a number of medical expenses related to cardiac concerns, and in most cases, things like heart surgery, heart medications and stays in skilled nursing facilities will fall under Original Medicare’s benefits. Unfortunately, things become a bit more complex when it comes to the three phases of cardiac rehab, and in particular, the third phase.
The reason for this is that Medicare coverage for outpatient medical expenses falls under Part B, prescription drug coverage falls under Part D and inpatient services fall under Part A, but there isn’t a provision specifically for things like exercise and wellness programs. As such, Original Medicare insurance patients often will not be able to receive coverage for the third phase of cardiac rehab, but they will generally be covered under phases one and two.
What further complicates matters is that phase three of cardiac rehab can be different for each patient, so there isn’t always a standardized level of care that is measured against. Some patients will require more rigorous exercise and weight loss regimens, while others may require a focus on dietary education. As such, some pieces of the third phase of cardiac rehab may be covered when ordered by a physician, but once again, as a general rule, the third phase of rehab as a whole is not specifically addressed by Medicare coverage.
Medicare Advantage and Three-Phase Cardiac Rehab
It should be noted that some cardiac patients who have Medicare Advantage plans may be able to receive additional coverage since Medicare Advantage plans sometimes provide benefits that fall outside of the coverage range of Original Medicare insurance. This may not be the case for all Medicare Advantage patients, however, so it would be a good idea to contact your plan and work with your cardiac care team to find an economical solution that also provides the level of care required to get you on the road to recovery.
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