April 8th 2024
By Ari Parker
Learn about abdominal aortic aneurysm (AAA) screening guidelines under Medicare and what your coverage options are.
By Ari Parker
An abdominal aortic aneurysm (AAA) is a bulging area of the abdominal aorta, the largest artery in the body. People often don’t know when they have an abdominal aortic aneurysm because they develop slowly over time and may not cause any symptoms until they become too large or rupture. That’s why it’s important to visit your doctor for frequent check-ups if you have certain risk factors like smoking, high blood pressure, or a family history of AAA.
Luckily, Medicare covers screenings and treatment if you’re at risk for AAA. Learn the guidelines for AAA screenings under Medicare and how much you’ll have to pay out of pocket in this post.
An abdominal aortic aneurysm (AAA) is a swelling or bulging area of the abdominal aorta. AAA can cause severe symptoms or rupture, leading to dangerous complications.
Medicare covers AAA screenings if you’re at risk for the condition. If you meet eligibility requirements, you’ll pay nothing for the ultrasound.
Treatment options for AAA include surgery, medication, and minimally invasive procedures. Medicare also helps cover these.
Abdominal aortic aneurysms occur in the abdominal aorta, which is a large artery that comes from the aortic arch located in your chest and runs through the abdomen. In other words, it spans from your heart to your abdomen. The abdominal aorta is responsible for supplying blood to the abdomen, pelvis, and legs.
An aneurysm, or an abnormal swelling in the wall of an artery, can form over many years, especially if you have certain risk factors like:
Atherosclerosis (when arteries harden)
High blood pressure
Diseases related to blood vessels
Infections in the aorta
Trauma from injuries or accidents
Smoking
Old age
Certain genetic conditions
Genetic history of AAA
Men are also more likely to develop AAA than women. If you experience abdominal or back pain, pulsating sensation in the abdomen, a rapid heart rate, or nausea and vomiting, it could be an aneurysm pressing against your surrounding organs or tissues. Get in touch with your doctor immediately if you experience any of these symptoms. Your doctor will likely order an AAA screening to check for the condition.
An AAA screening involves an assessment of your physical health, medical history, and ultrasound imaging to examine the bulge on your artery. The average cost of an ultrasound without insurance is between $100 and $1,000 without insurance, depending on where you live. Thankfully, Medicare covers the cost of an AAA screening.
There’s a couple guidelines you should note to receive coverage for an AAA screening with Medicare. We’ll go over eligibility requirements, how often Medicare will cover the screening, and how much you’ll have to pay out of pocket.
If you’re at risk, you meet the eligibility criteria, and your healthcare provider accepts the Medicare-approved costs, you won’t have to pay anything for the screening.
Only people who are at risk for AAA can get coverage for a screening with Medicare. Medicare will pay for the screening if you check any of the following:
You’re a man between 65-75 years old, and you’ve smoked at least 100 cigarettes in your lifetime
You have a family history of abdominal aortic aneurysms
You have a referral from a doctor or healthcare provider
Medicare will only cover an abdominal aortic aneurysm screening ultrasound once in your lifetime if you meet the eligibility criteria above. If your healthcare provider recommends you get screened multiple times, you may have to cover the service yourself. Certain Medicare Advantage plans may help cover additional screenings—check with your insurance or healthcare provider to be certain.
Once your doctor assesses the condition, they may recommend a few treatment options for you depending on:
The size and location of the aneurysm
The rate of growth
Your overall health
The severity of symptoms
Below, you’ll find some ways you can treat AAA.
Consistent monitoring: If the AAA is small (less than 5.5 centimeters in diameter) and not rapidly growing, your doctor may recommend regular monitoring with more imaging tests to track any changes.
Surgery: You may need surgery if your AAA is larger or if the risk of rupture is high. Surgery for AAA involves making a large incision in the abdomen to access the aneurysm. Surgeons replace the weakened area of the aorta with a synthetic graft, which supports the aorta and prevents it from rupturing.
Endovascular Aneurysm Repair (EVAR): If you’re at higher risk for complications from surgery, your doctor may recommend EVAR. EVAR is a minimally invasive procedure that involves inserting a medical device in the body to seal off the aneurysm and promote normal blood flow.
Medication: In some cases, your doctor may prescribe medications to manage underlying conditions that worsen or contribute to AAA. These conditions include high blood pressure or high cholesterol. However, medications can’t repair the aneurysm.
Medicare covers any treatment you’ll need to heal or repair an abdominal aortic aneurysm, including surgery. Once you meet your Part B deductible, you’ll pay 20% of the costs of the surgery. If you have a medicare Supplement plan, your costs will be reduced according to your plan benefits. If you have a Medicare Advantage plan, check your summary of benefits or contact your provider’s billing department for information about your out-of-pocket costs for the surgery.
You can check your Medicare Part D prescription drug plan’s formulary to see if medications used to manage AAA or AAA-related conditions are covered.
Having an abdominal aortic aneurysm can be scary, and early detection is the key to successful intervention. Focus on your health and leave the Medicare questions to us! Call us at 855-900-2427 or schedule a time to chat if you have question or concerns about your Medicare coverage.
