Abdominal aortic aneurysm (AAA) is a ballooning of the heart valve (aorta). When left untreated, aortic ruptures can cause life-threatening internal bleeding. Screening can help determine if you need medical treatment for AAA.
Medicare Part B covers a one-time AAA ultrasound if you are at risk for AAA and receive a referral from your provider. Medicare considers you at risk for AAA if:
- You have a family history of AAA
- Or, you are a man age 65-75 and have smoked 100 or more cigarettes in your lifetime
Keep in mind that Medicare only covers the AAA ultrasound once in your lifetime. If your provider suggests that you receive a second AAA ultrasound, Medicare may deny coverage. This means you would be responsible for the full cost of the service. Be sure to ask why your provider is recommending that you receive more than one AAA ultrasound, and how much you may have to pay for it.
If you qualify, Original Medicare covers a one-time AAA screening at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover a one-time AAA ultrasound without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.
During the course of your AAA screening, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.