Medicare covers cholesterol testing as part of the covered cardiovascular screening blood tests. Medicare also includes tests for lipid and triglyceride levels. These tests are covered once every 5 years.
However, if you have a diagnosis of high cholesterol, Medicare Part B will usually cover continuing blood work to monitor your condition and your response to prescribed medication.
Cholesterol medication is usually covered by Medicare Part D (prescription drug coverage).
Keep reading to learn more about what Medicare covers to help diagnose and prevent cardiovascular disease.
The cholesterol test is used to estimate your risk for heart disease and blood vessel disease. The test will help your doctor evaluate your total cholesterol and your:
- Low-density lipoprotein (LDL) cholesterol. Also known as “bad” cholesterol, LDL in high quantities can cause the buildup of plaques (fatty deposits) in your arteries. These deposits can reduce blood flow and can sometimes rupture, leading to a heart attack or stroke.
- High-density lipoprotein (HDL) cholesterol. Also known as “good” cholesterol, HDL helps carry away LDL cholesterol and other “bad” lipids to be flushed from the body.
- Triglycerides. Triglycerides are a type of fat in your blood that is stored in fat cells. At high enough levels, triglycerides may increase risk of heart disease or diabetes.
Cholesterol testing isn’t the only thing Medicare covers to help identify, prevent, and treat cardiovascular disease.
Medicare will also cover an annual visit with your primary care doctor for behavioral therapy, such as suggestions for a heart-healthy diet.
Medicare covers other prevention and early detection services — many at no charge — to help you identify health problems early. Catching diseases early can maximize the success of the treatment.
These tests include:
|abdominal aortic aneurysm screening||1 screening for people with risk factors|
|alcohol misuse screening and counseling||1 screen and 4 brief counseling sessions per year|
|bone mass measurement||1 every 2 years for people with risk factors|
|colorectal cancer screenings||how often is determined by the test and your risk factors|
|depression screening||1 per year|
|diabetes screening||1 for those at high risk; based on test results, up to 2 per year|
|diabetes self-management training||if you have diabetes and a written doctor’s order|
|flu shots||1 per flu season|
|glaucoma tests||1 per year for people with risk factors|
|hepatitis B shots||series of shots for people at medium or high risk|
|hepatitis B virus infection screening||for high risk, 1 per year for continued high risk; for pregnant women: 1st prenatal visit, time of delivery|
|hepatitis C screening||for those born 1945–1965; 1 per year for high risk|
|HIV screening||for certain age and risk groups, 1 per year; 3 during pregnancy|
|lung cancer screening test||1 per year for qualified patients|
|mammogram screening (breast cancer screening)||1 for women 35–49; 1 per year for women 40 and older|
|medical nutrition therapy services||for qualified patients (diabetes, kidney disease, kidney transplant)|
|Medicare diabetes prevention program||for qualified patients|
|obesity screening and counseling||for qualified patients (BMI of 30 or more)|
|Pap test and pelvic exam (also includes a breast exam)||1 every 2 years; 1 per year for those at high risk|
|prostate cancer screenings||1 per year for men over 50|
|pneumococcal (pneumonia) vaccine||1 vaccine type; other vaccine type covered if given 1 year after first|
|tobacco use counseling and tobacco-caused disease||8 per year for tobacco users|
|wellness visit||1 per year|
If you register at MyMedicare.gov, you can get direct access to your preventive health information. This includes a 2-year calendar of the Medicare-covered tests and screenings you’re eligible for.
Every 5 years, Medicare will cover costs to test your cholesterol, lipid, and triglyceride levels. These tests can help determine your risk level for cardiovascular disease, stroke, or heart attack.
Medicare covers other preventive services as well, from wellness visits and mammogram screenings to colorectal cancer screenings and flu shots.