Stroke Awareness, Medicare Coverage and Prevention

Strokes can happen to anyone, at any age. Having a stroke puts a person at higher risk for a second one. Knowing the signs of a stroke can save a life. Don’t wait—act FAST! You can prevent a serious stroke by being aware of the symptoms.

A stroke can be a life-altering event. It leaves stroke survivors and their families grappling with unforeseen physical, emotional, and financial challenges. It’s often referred to as a “brain attack.” A stroke occurs when blood flow to a part of the brain is interrupted. And causes brain cells to die from deprivation of oxygen and essential nutrients. While strokes may appear as unpredictable events, certain factors can heighten susceptibility. Age plays a key role, with the risk rising as a person enters their golden years, particularly after the age of 55. This reminder stresses the importance of people taking proactive steps to safeguard their health as they age.

Yet, age is just the tip of the iceberg when it comes to stroke risk. High blood pressure, also known as hypertension, stands as a major contributor. The condition weakens blood vessels, rendering them more prone to clotting or rupturing. As a result, maintaining healthy blood pressure levels appears as a vital defense against stroke. But that’s not all. Lifestyle choices like smoking, an unhealthy diet laden with saturated and trans fats, and physical inactivity all fuel the flames of risk.

Stroke Prevention

The best way to prevent a stroke is to eat a healthy diet, exercise regularly, and avoid smoking and drinking alcohol. Keeping a healthy weight can reduce risks. It helps with arteries not becoming clogged with fatty substances (atherosclerosis). Clogged arteries lead to high blood pressure because it makes the heart work more to push blood flow to the organs.

It's important to keep your blood pressure at normal levels. High blood pressure, also called hypertension, is the leading cause of strokes. Half of all men – 52% – and 43% of women in the U.S. have blood pressure that is too high, according to AHA statistics . While it can be controlled through lifestyle changes or by taking medication, only about 1 in 5 adults keep it properly managed.

At-home monitoring and regular communication with doctors to make sure blood pressure medications are working are important.

What Does Medicare Pay for After a Stroke?

After having a stroke, understanding Medicare coverage can be critical to the recovery journey. Here’s a concise breakdown of what Medicare generally covers post-stroke.

Inpatient Rehabilitation: Under Medicare Part A, inpatient rehab is covered when the doctor determines it’s medically necessary for recovery post-stroke. However, be aware of potential deductibles, coinsurance payments, and limits on hospital days.

Skilled Nursing Care: Medicare Part A can also cover Skilled Nursing Care needed post-stroke. To qualify, the individual must meet the Skilled Nursing Facility (SNF) requirements. The costs associated with SNF care are consistent regardless of whether a person had a stroke or seeking care for other reasons.

Long-Term Care: If the person’s health declines to the point where long-term care is required, be cautious. Medicare generally won’t cover this if it’s the sole care needed. Especially when it pertains to non-medical services such as bathing, feeding, or restroom assistance.

Walkers: If mobility is an issue, Medicare Part B cover walkers with a doctor’s prescription. Both 2-wheel and 4-wheel walkers are typically covered. Medicare pays 80% of the total cost and the member pays the other 20%.

Medicare Advantage Plans for Stroke Patients

Medicare Advantage Plans, also known as Part C, offer an alternative way to receive Medicare benefits. These plans are offered by private insurance companies approved by Medicare. Many Medicare Advantage plans provide added benefits and services beyond what’s offered by Original Medicare (Parts A and B). If you’re considering a Medicare Advantage plan, be sure to review the plan details carefully. A licensed insurance agent is a great resource when trying to understand a plan’s coverage for stroke-related services and rehab.

Regular check-ups and preventive care can make all the difference in a patient’s recovery journey.

Additionally, many Medicare Advantage plans consolidate their care and include (Parts A, B and D) and costs under one umbrella. This simplifies the health care experience during a challenging time. Before signing up for a Medicare Advantage plan be sure to compare different plans. And be sure preferred providers and facilities are within the plan’s network.

Medicare Supplement Insurance Policies for Stroke Patients

Medicare Supplement Insurance policies, often referred to as Medigap, fill in the gaps left by Original Medicare. These policies help cover some of the out-of-pocket costs, such as copayments and deductibles. While Medigap policies don’t provide new services, they can reduce financial burden. This helps a person focus on recovery instead of worrying about bills.

For stroke patients, these supplement policies can be valuable. A stroke often results in unexpected medical expenses—from hospital stays to rehab therapies and long-term care.

What You Should Know

In the aftermath of a stroke, focus should be on recovery. Understanding different options can make a world of difference. And allows an individual to access the care they need without the added stress of financial uncertainty.

Medicare provides coverage for stroke patients including hospital care, outpatient services, and rehab. It empowers patients to regain their independence and improves quality of life. Original Medicare, Medicare Advantage and Medicare Supplement Insurance are all great choices for stroke patients. Be sure to take the time to assess health care needs for a smoother and less stressful road to recovery.

For more information about Original Medicare, Medicare Advantage and Medicare Supplement Insurance give us a call at the Medicare Support Center at CVS 1-844-672-0317 (TTY: 711). Our licensed insurance agents can help you assess your current coverage. And work with you to explore other plan options so you’re confident with finding a plan that’s right for you.

MR1059(4) 3/2024