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Does Medicare Cover Abdominal Aortic Aneurysm Screenings?

by David Bynon, May 2, 2014

Abdominal Aortic AneurysmAn abdominal aortic aneurysm is a bulging, weakened area in the wall of the aorta resulting in an abnormal widening (ballooning) that’s in excess of 50 percent of the normal diameter.  Most arterial aneurysms form in the abdominal aorta below the kidneys. This is called an infrarenal aneurysm.

Aneurysms frequently continue to increase in size and progressively weaken the artery wall.  When this happens, surgical intervention may be needed to prevent a rupture.  Prior to any type of therapy a thorough screening is necessary.

Medicare Covers Abdominal Aortic Aneurysm Screening

[inpostad]If you have Medicare, your Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. (Medical Insurance) covers a one-time abdominal aortic aneurysm ultrasound. You must ask your doctor for a referral. Your doctor will give you the referral if you are at risk.  As far as Medicare is concerned, you’re considered “at risk” if you meet one of these criteria:

  • You have a family history of abdominal aortic aneurysms.
  • You’re a man age 65 to 75 and have smoked at least 100 cigarettes in your lifetime.

You pay nothing for this test if your health care providerA person or organization that’s licensed to give health care. Doctors, nurses, and hospitals are examples of health care providers. accepts Medicare assignmentAn agreement by your doctor to be paid directly by Medicare, to accept the payment amount Medicare approves for the service, and not to bill you for any more than the Medicare deductible and coinsurance..

What Is An Abdominal Aortic Aneurysm Screening?

In addition to a complete medical history and physical examination, diagnostic procedures to screen for and diagnose an aneurysm may include a combination, of the following:

  • CT scan (computed tomography) – this is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images, both horizontally and vertically, of the body.  The images (slices) show minute details of the body, including the bones, muscles and organs.
  • MRI (magnetic resonance imaging) – this is a diagnostic system that uses a combination of large magnets, radio frequencies, and a computer to create detailed images of organs and structures within the body.
  • Ultrasound – this is a diagnostic system that uses high-frequency sound waves and a computer to produce images of blood vessels, tissues, and organs. Ultrasounds machines are commonly used to actively view internal organs as they function. They can also help to assess blood flow through various vessels.
  • Arteriogram (angiogram) – this is an x-ray image of blood vessels that helps detect and evaluate aneurysm, stenosis, and blockages. Prior to imaging, a dye is injected into an artery to make blood vessels visible on x-ray.

What If Your Doctor Recommends A Screening Not Covered By Medicare?

Your doctor may recommend that you get services not covered by Medicare or more often than Medicare normally covers. When this happens, you may have to pay some or all of the costs.  If you have Original Medicare or Original Medicare and a Medigap policy, coverage is based on the Medicare guidelines. If you are enrolled in a Medicare Advantage plan, your minimum coverage is the same as Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., but may include additional coverage. Before accepting a screening that you may not need, ask questions so you understand why your doctor is recommending the service.

Ref: Abdominal Aortic Aneurysm

Filed Under: What Does Medicare Cover? Tagged With: Medicare Advantage, Medicare Benefits, Original Medicare

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