Does Medicare Cover Broken Heart Syndrome?

Steven Mott by Steven Mott | Licensed since 2012
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This article was updated on: 10/21/2018

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Broken heart syndrome might sound like an emotional condition, not a medical condition – but it’s real, according to the National Institutes of Health (NIH). Let’s explore Medicare coverage and broken heart syndrome.

What is broken heart syndrome?

According to the National Institutes of Health (NIH), broken heart syndrome is a condition that affects your heart. Also known as stress-induced cardiomyopathy, broken heart syndrome happens when the heart muscle fails due to emotional stress. People who experience broken heart syndrome are often healthy, with no history of heart problems.

People usually recover from this condition, the American Heart Association reports.

What causes broken heart syndrome?

According to the American Heart Association, if you experience extreme emotional stress – such as the death of a loved one – stress hormones can surge, and the heart temporarily enlarges. It often contracts more forcefully than normal, and you may feel intense chest pain.

The NIH reports that broken heart syndrome tends to afflict women more than men – and older women at that (those past menopause).

How do doctors treat broken heart syndrome?

Some doctors might incorrectly diagnose broken heart syndrome as a heart attack, notes the NIH. Symptoms are very similar, but generally arteries are not blocked with stress-induced cardiomyopathy (broken heart syndrome).

The NIH reports that researchers are exploring broken heart syndrome, its causes, and how to treat it. The Mayo Clinic states that doctors generally treat broken heart syndrome as they would treat a heart attack. Treatment may include prescription medications, such as beta blockers, diuretics, or angiotensin-converting enzyme (ACE) inhibitors.

Does Medicare cover broken heart syndrome?

If you go to the hospital because of broken heart syndrome, and you’re admitted as an inpatient, Medicare Part A generally covers your treatment, hospital services, and any medications given to you as part of that treatment. The Part A deductible applies.

Medicare Part B may cover treatment in an outpatient setting, such as a clinic or emergency room. If health-care providers administer any medications in this outpatient setting, Part B might cover them. The Part B deductible, along with coinsurance amounts, may apply.

However, outside of hospital and outpatient settings, Original Medicare (Part A and Part B) generally don’t cover prescription drugs. Click here to learn about Medicare Part D prescription drug coverage.

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