Does Medicare cover treatment for high cholesterol

Does Medicare cover treatment for high cholesterol? 

Cholesterol, a waxy substance that resides in your bloodstream, has become a household term with a bad reputation. Actually, cholesterol is essential to building healthy cells and is important to cell membrane structure. However, your body only needs a small amount of cholesterol to perform its role in keeping you healthy. Too much of it is a risk factor in cardiovascular disease. 

Good and bad cholesterol

Cholesterol belongs to a family of organic compounds known as lipids. Since blood is mostly water and fat cannot be dissolved in water, fat-related lipids can’t travel alone in your bloodstream. So lipids get a ride from lipoproteins. Lipoproteins are like small packages of protein wrapped around cholesterol and other fat-related substances. With protein on the outside, lipoproteins are able transport lipids through your bloodstream and deliver them where they need to be for a healthy metabolism.

Lipoproteins are described in terms of their density, referring to the proportion of protein, fat and cholesterol that each contains. A high-density lipoprotein (HDL), which contains 55% protein, directs cholesterol away from arteries and is considered a source of good cholesterol. A low-density lipoprotein (LDL) is made up of about 20% protein and continuously transfers cholesterol to the tissues, so it is referred to as bad. Your body makes its own cholesterol, produced in the liver. Food is not a source of HDL. 

Medicare Part B and Part D benefits

The good news from the American Heart Association is that you can lower your bad cholesterol and, thereby, lower your risk of a stroke or heart disease. Medicare benefits can help. Medicare Part B covers screenings for cardiovascular disease with a blood test that detects lipid levels. Based on your test results, your doctor may recommend lifestyle changes and/or medication to reduce your risk.  

Your Medicare benefits provide these screenings once every five years at no charge to you if the tests are administered by a health care practitioner who accepts assignment. Accepting assignment means that your provider accepts the Medicare-approved payment and will not charge you unless a deductible or coinsurance is applicable. 

If your doctor recommends medication, review the formulary provided by your prescription drug plan (Part D) to check if it is covered. A formulary is a tiered list of covered prescription drugs, also known as a drug list. Your plan would inform you if a deductible or copay applies for each tier. If a brand prescription is not covered or the copay is high, you can ask your doctor if a generic version covered by your plan might be as effective.

Preventing high cholesterol

To protect your cardiovascular health, the American Heart Association recommends that you:

• Eat a heart-healthy diet. Limit red meat, whole-milk dairy products and fried food in favor of vegetables, fruits, whole grains, fish, poultry, nontropical oil and nuts.
• Increase physical activity to a minimum of 150 minutes per week with aerobic exercises like brisk walking, biking and swimming.
• Stop smoking and vaping. These behaviors are risk factors for other diseases as well.
• Maintain a healthy weight. Lowering weight by even 5% to 10% can make a difference in cholesterol levels.