According to the Centers for Disease Control and Prevention (CDC), nearly 29 million adult Americans have high cholesterol levels (higher than 240 mg/dL). Having high blood cholesterol raises the risk for heart disease, the leading cause of death, and for stroke, the fifth leading cause of death.

Original Medicare Coverage
For High Cholesterol

Original Medicare covers a number of high cholesterol medical services.

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. Most people pay a monthly premium for Part A. To fully cover your potential Part A expenses, you have to additionally purchase a Medicare (Medigap) supplement or a Medicare Advantage plan.

Part B covers doctors’ services, outpatient care, medical supplies, and preventive services. Everyone pays a monthly premium for part B. In most cases, that fee is deducted from monthly social security benefit payments. To fully cover your potential Part B expenses, you have to additionally purchase a Medicare (Medigap) supplement, or a Medicare Advantage plan.

Part D covers a portion of prescription drug costs. To get full Part D coverage you have to join a private Medicare approved drug plan or purchase a Medicare Advantage plan that provides Part D coverage.

Logic would suggest that Original Medicare should have a Part C. Well, actually there is a Part C; but Part C is not part of Original Medicare. Rather, Part C is Medicare Advantage.

Read more about Original Medicare.

Medicare Supplement Coverage
For High Cholesterol

A Medicare Supplement policy (often referred to as a Medigap policy) is an optional addition to Original Medicare. Medicare Supplements are sold by private insurance companies. Supplement policies pay for some of the potentially very large health care cost gaps that Original Medicare does not cover.

Read more about Medicare Supplements.

Medicare Advantage Coverage
For High Cholesterol

Medicare Part C is Medicare Advantage. Medicare Advantage Plans generally involve HMO or PPO health care organizations. They are provided and operated by private companies (as opposed to the Federal government).

Medicare Advantage Plans provide Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Most plans also include Part D Prescription Drugs and many also provide additional coverage for vision, hearing, dental, wellness programs, transportation to and from doctors and possibly over the counter pharmacy products.

Read more about Medicare Advantage health insurance.

AHCCCS Medicaid Coverage
For High Cholesterol

In Arizona, the state Medicaid department (AHCCCS) provides Chronic Special Needs health insurance plans for low income seniors, and other Medicare eligible individuals, who have been diagnosed with high cholesterol.

Availability of specific Special Needs Plans varies from county to county and the cost can vary from no cost (for fully eligible AHCCCS members) to low cost (for members who have too much income to qualify for full AHCCCS coverage but are nonetheless living on a limited income).

High cholesterol health insurance coverage provides all of the services that the federal government requires for Medicare Advantage plans. In addition, many plans coordinate with a Medicare Advantage plan to provide additional benefits. Some AHCCCS Chronic Special Needs plans also provide a care coordinator who works to provide members with the right care, at the right time, from the right providers.

For seniors who have both Medicare and AHCCCS Medicaid, most of the costs of participating in a high cholesterol coverage will be covered by federal and state governments.

Read more about AHCCCS Medicaid.

High Cholesterol

Get Help From ACCESSMed

Determining the best Medicare insurance plan for high cholesterol is complicated. Nonprofit ACCESSMed Foundation can help. And, there is no fee for our services.

Get help by clicking on the GET HELP button at the bottom of this page.

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