How Often Will Medicare Pay for a Blood Lipid Panel?
Medically Reviewed by Vincenta Faulkner, RD, CNSC, CCTD
Cardiovascular disease is among the leading causes of death in the United States. Especially as we age, the risks of cardiovascular disease tend to increase drastically.
It doesn’t help that monitoring our health with methods like blood lipid panels can be confusing, not only in their complexity but also the testing itself and, most importantly, how it will be paid for.
More often than not, people who need blood lipid panels tend to be on pensions or Social Security. Every dollar counts.
That’s why we’re here to clear things up about the process of getting a blood lipid test. We’ll let you know how often Medicare will pay for your test, as well as other important information so that you’ll know everything you need to when you go in to monitor your heart health.
Better healthcare starts with better access, and Zizi offers monthly heart monitoring without the hoops.
What Is a Blood Lipid Panel?
First things first, let’s get a little clarity about what exactly a blood lipid panel is.
A lipid panel tests your blood, measuring fatty molecules in your bloodstream called lipids. This panel includes mostly measurements of your cholesterol levels and your triglyceride levels. Both cholesterol and triglycerides are crucial for healthy cells, but a buildup of either type of fat can cause health issues.
The tests in a blood lipid panel tend to measure:
- Low-density lipoprotein (LDL): Low-density lipoprotein, or LDL, is also known as “Bad Cholesterol”. Lowering LDL is the best way to reduce your risk of having a heart attack or stroke, and the goal of the Zizi program is for you to lower this number. You want this number to be as low as possible.
- High-density lipoprotein (HDL): High-density lipoprotein, or HDL, is also known as “Good Cholesterol”. HDL removes cholesterol from the bloodstream. You want this number to be as high as possible.
- Triglycerides (TG): Triglycerides, or TG, are a specific type of fat in the blood. Like LDL (“Bad Cholesterol), you want this number as low as possible.
-
Total Cholesterol (TC): Total cholesterol, or TC, is the total amount of both good and bad cholesterol in your body. It reflects your risk for heart disease. If it is elevated, your risk of having a heart attack or stroke is elevated.
This high-definition measurement of the lipids, or blood fat, in your bloodstream is good information for people concerned about their risks. Now let’s get into how you pay for this essential panel.
Costs of a Blood Lipid Panel
Having blood drawn is enough to get some people sweating; it doesn’t help that your wallet may also end up bleeding a little because of traditional healthcare costs.
Given the complicated way health insurance operates, prices for a blood panel can range wildly without insurance. People may have to pay anywhere from 200 to 1000 dollars for a test when paid out of pocket.
Now that’s no way to keep your blood pressure down.Alternatively, blood lipid panels become much more affordable with insurance like Medicare.
How Often Does Medicare Cover Blood Lipid Panels?
Generally, Medicare will cover a blood lipid panel once every five years as per its status as a diagnostic service under Medicare Part B.
Five years, especially as we get older, can feel like a really long time. And when we are already at increased risk for cardiovascular disease in our golden years, it simply is too long a gap for people who need to keep a closer eye on their cholesterol levels.
Thankfully, that gap can be reduced if your doctor or general practitioner concludes that your health requires it. For folks who have a high risk of developing cardiovascular disease or if you have high cholesterol, you have the option of requesting a change to the frequency of your blood panels via Part B of your Medicare insurance.
Your doctor will help you figure out how often you require a panel, but a care coordinator may be able to help you clear that up with your insurance. Alternatively, you can contact your insurance provider for clarity regarding what services are or are not covered.
Additionally, people enrolled in Medicare Advantage Plans may have more comprehensive access to blood panels. This is determined by the insurers themselves, which would require you to reach out to them and assess how they can help you gain access to more blood lipid panels.
Let’s get into these avenues of gaining access to more blood panels: Medicare Part B and Medicare Advantage, so you have a better understanding of the extent of your coverage concerning blood lipid tests.
What Does Medicare Part B Include?
Medicare Part B describes the kind of coverage you receive from Medicare as separate from Part A. To clarify, the type of coverage under the umbrella of Part B tends to focus on medically necessary services and preventative services.
Medicare Part B also covers:
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Limited outpatient prescription drugs
- Mental health
- Inpatient
- Outpatient
- Partial Hospitalization
If your health makes it necessary, you can access more lipid panels under your Part B Medicare coverage. Establishing that medically necessary coverage is a matter of connecting with your doctor or medical provider based on your health conditions, then going to your insurance.
If your cholesterol levels warrant it, or if you are at risk for heart disease, talk to your medical professional about how you might be able to expand your Medicare Part B coverage.
What Does Medicare Advantage Even Mean?
As opposed to Part A and Part B, Medicare Advantage Plans function as a sort of Medicare “Part C.” These are plans that are Medicare-approved and work in conjunction with private companies, giving you the option of using prior private healthcare coverage in tandem with your Medicare benefits.
This gives you an added advantage that comes with the namesake. If you have a Medicare Advanced Plan, you may have the opportunity to expand your coverage for access to, in this case, more blood lipid panels.
If your health warrants it, be sure to let your doctors or medical professionals know that you are interested in using this advantage for wider access to coverage. It’s also important to reach out to your insurers to clarify the extent of your coverage.
If you have access to the expanded coverage, you should absolutely make the best of it to ensure that you get the most out of your insurance.
Getting Your Blood Lipid Panel
After it’s been cleared with your insurance and your doctor or medical professional, you’ll be referred to a phlebotomist to have blood drawn. The hardest process is getting your insurance in order, clearing it with your medical professional, and finally getting to the phlebotomist to have your blood is drawn.
Heart Health Made Easy With Zizi
For people looking to monitor their cholesterol levels with ease, we encourage you to check out our at-home cholesterol tests. The process of clearing your insurance, getting everything in order, and going to a clinic to have blood drawn can be excessively time-consuming and stressful.
Zizi offers commonsense care, including regular lipid testing, natural supplements, and a heart health course.
Zizi’s mission is to help people concerned about their cholesterol levels find peace of mind managing their health without the added stresses of navigating insurance packages. Cholesterol-related illnesses don’t need to happen. We can monitor our health and take active measures to ensure that we do our best to keep our heart health a priority.
Explore Zizi today to see how it can help keep you healthy while keeping health easy.
Sources:
Does Medicare Cover Lipid Panel? | Medicare.org
What Part B covers | Medicare.org
Medicare Advantage Plans | Medicare.org
Lipid Panel | Johns Hopkins Medicine.
What Your Cholesterol Levels Mean | American Heart Association
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