Quick Answer
Yes, Medicare covers AFib treatments including cardioversion, catheter ablation, EKGs, and heart monitors when medically necessary. Part A covers inpatient hospital stays for AFib procedures. Part B covers outpatient services including cardiologist visits, EKGs, and catheter ablation. Prescription drugs like Eliquis are covered under Part D.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Medicare Part A (Inpatient) | Covered | Covers inpatient hospital stays for cardioversion, surgical ablation, and cardiac procedures |
| Medicare Part B (Outpatient) | Covered | Covers cardiologist visits, EKGs, heart monitors, outpatient cardioversion, catheter ablation |
| Medicare Advantage (Part C) | Covered | Must cover same services as Original Medicare; usually includes Part D drug coverage for Eliquis |
| Medicare Supplement (Medigap) | Varies by Plan | Fills gaps in Original Medicare - covers Part A deductible, Part B coinsurance, and excess charges |
Understanding Your Coverage Options
Original Medicare (Parts a & B)
Covered when medically necessaryOriginal Medicare covers a wide range of AFib treatments when medically necessary. Atrial fibrillation affects an estimated 2.7 million U.S. adults and can lead to stroke or blood clots, making prompt diagnosis and treatment essential.
**Medicare Part A** covers inpatient hospital stays for AFib procedures including cardioversion, surgical ablation, and the Maze procedure. **Medicare Part B** covers outpatient services including cardiologist visits, EKGs, Holter monitors, event monitors, and catheter ablation performed in an outpatient setting.
Prescription blood thinners like Eliquis, Xarelto, and Warfarin are not covered under Part A or Part B - these require a separate Medicare Part D prescription drug plan.
What It Covers
- Inpatient hospital stays for AFib procedures (Part A)
- Cardioversion - both electrical and chemical
- Catheter ablation (outpatient or inpatient)
- EKGs and cardiac diagnostic tests
- Heart monitors (Holter monitors, event monitors)
- Cardiologist visits and specialist consultations
- Cardiac rehabilitation programs
What It Doesn't Cover
- Prescription drugs like Eliquis (covered under Part D)
- Routine checkups not related to AFib diagnosis
- Experimental or non-FDA-approved AFib treatments
Part B: You pay 20% coinsurance after the $283 annual deductible (2026). Part A: You pay $0 after the $1,736 per-benefit-period deductible for days 1–60 of a hospital stay.
Medicare Advantage (Part C)
Covered - cost-sharing varies by planMedicare Advantage plans are required by law to cover everything that Original Medicare covers, including all AFib treatments. Many Advantage plans also include Part D drug coverage, which is critical for AFib patients who take daily blood thinners like Eliquis.
Without insurance, one month of Eliquis can cost $499. Most Medicare Advantage plans that include drug coverage (MAPD) cover Eliquis at a significantly lower cost. However, Advantage plans use provider networks - confirm your cardiologist and ablation specialist are in-network before scheduling procedures.
What It Covers
- All Original Medicare AFib benefits (Parts A & B)
- Usually includes prescription drug coverage for Eliquis, Xarelto, and other blood thinners
- May include additional cardiac wellness benefits
- Special Needs Plans (SNPs) available for chronic conditions
What It Doesn't Cover
- Out-of-network providers unless your plan allows it
- Services requiring prior authorization that was denied
Costs vary by plan. Most Advantage plans have lower premiums but higher out-of-pocket costs for specialist visits and procedures compared to Medigap.
Verify Your Cardiologist is In-network
Medicare Advantage plans require you to use in-network providers for the lowest costs. If your cardiologist or ablation specialist is out-of-network, your costs could be significantly higher. Always verify before scheduling.
Medicare Supplement (Medigap)
Covers some or all of Original Medicare's cost-sharingMedicare Supplement (Medigap) plans pay the out-of-pocket costs that Original Medicare leaves behind - including the 20% Part B coinsurance and the Part A deductible. For AFib patients who may need multiple procedures and frequent specialist visits, Medigap can provide significant financial protection.
Medigap Plan G is the most popular option for AFib patients. It covers all Medicare-approved costs except the Part B deductible ($283 in 2026). Unlike Medicare Advantage, Medigap has no provider networks - any doctor who accepts Medicare will also accept your Medigap plan.
**Important:** If you are diagnosed with AFib before enrolling in Medicare, you can still get a Medigap plan - but only during your Open Enrollment Period or when you have a guaranteed issue right. Outside these windows, insurers can deny coverage or charge higher premiums due to your pre-existing condition.
What It Covers
- Part A hospital deductible and coinsurance
- Part B coinsurance (20%) for all AFib outpatient services
- Part B excess charges (Plan F and Plan G)
- Foreign travel emergency coverage (Plans C, D, F, G, M, N)
What It Doesn't Cover
- Prescription drugs - you need a separate Part D plan
- Dental, vision, or hearing benefits
Plan G covers all Medicare-approved costs except the Part B deductible ($283 in 2026). Monthly premiums vary by age, location, and insurer.
Estimated AFib Treatment Costs with Medicare
| Procedure | Medicare Part | Without Supplement | With Plan G |
|---|---|---|---|
| EKG (outpatient) | Part B | ~$20–$40 (20% of approved amount) | $0 after Part B deductible |
| Cardioversion (outpatient) | Part B | ~$200–$400 (20% of approved amount) | $0 after Part B deductible |
| Catheter ablation | Part A or B | $3,200–$4,400 (20% of $16K–$22K) | $0 after Part B deductible |
| Inpatient hospital stay | Part A | $1,736 deductible per benefit period | $0 |
| Eliquis (monthly) | Part D | $0–$47 (varies by plan tier) | Part D plan required (separate) |
✦ Important Coverage Rules for AFib
Medical Necessity Requirement
All AFib treatments must be deemed medically necessary by your doctor. Medicare will not cover procedures ordered purely for preventive or elective reasons without a documented diagnosis.
Medigap Enrollment Timing
If you are diagnosed with AFib before enrolling in Medicare, you can still get a Medigap plan - but only during your Open Enrollment Period or when you have a guaranteed issue right. Outside these windows, insurers can deny coverage or charge higher premiums due to your pre-existing condition.
Medicare Advantage Network Restrictions
Medicare Advantage plans require you to use in-network providers for the lowest costs. If your cardiologist or ablation specialist is out-of-network, your costs could be significantly higher.
Part D Drug Formularies
Not all Part D plans cover every AFib medication at the same tier. Eliquis, Xarelto, and Warfarin may be covered at different cost levels. Always check your plan's formulary before enrolling.
AFib Treatments Medicare Covers
Medicare covers a broad range of treatments for atrial fibrillation. Here is a checklist of procedures and services that are typically covered when medically necessary:
Covered AFib Treatments
- Electrical cardioversion (low-voltage shock to restore rhythm)
- Chemical cardioversion (IV medications in a hospital setting)
- Catheter ablation (minimally invasive, blocks abnormal electrical signals)
- Surgical ablation / Maze procedure (open-heart surgery for complex cases)
- Cox-Maze and Mini-Maze surgeries
- Hybrid ablation surgery
- EKGs and cardiac monitoring (Holter monitors, event monitors)
- Cardiologist visits and specialist consultations
- Cardiac rehabilitation programs
- Prescription blood thinners (Eliquis, Xarelto, Warfarin) via Part D
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare. She trains agents on CMS compliance guidelines.