Does Medicare Cover the Zio Patch?

It is common for a person to experience irregular heartbeats every now and again. However, frequent irregular heartbeats may also indicate an underlying cardiac condition that needs medical care.

The Zio patch is a medical device that not only monitors your heart’s rhythm but also keeps the data stored for later analysis.

So a common question many people have is, “does Medicare cover the Zio patch?” In this article, we answer that question in clear, plain English. You will also find the average costs of the Zio patch and other helpful info.

Does Medicare Cover the Zio Patch?

The short answer is yes; Medicare will cover the cost of the Zio patch.

But this is not the case 100% of the time. As is often the case with Medicare, certain conditions must be met for Medicare to pay for your Zio patch. Below we look at what these are so you know what to expect.

Original Medicare Coverage of the Zio Patch

Original Medicare (Medicare Part A and Part B) provides coverage for the Zio patch. This plan provides coverage for your Zio patch if it is considered medically necessary.

The patch must be ordered by your healthcare provider for Original Medicare to provide coverage.

Which part of Original Medicare covers the Zio Patch?

Part A vs. Part B Coverage of the Zio Patch

Zio patch is covered by Medicare Part B as it takes place in an outpatient setting. Once approved, Medicare Part B covers 80 percent of the costs of your Zio patch. You will pay for the remaining 20 percent.

Medicare Advantage Coverage of the Zio Patch

The Medicare Advantage plans (Medicare Part C) also provide coverage for the Zio patch. These plans have to cover everything Original Medicare covers but will offer additional benefits as well.

Exactly what each plan covers and how much the out-of-pocket costs are depends on what plan you get.

How Much Does The Zio Patch Cost?

The Zio patch costs around $350. This price is unlikely to vary greatly.

How Does The Zio Patch Work?

The medical device is attached to the patient’s skin. It is equipped with a medical-grade adhesive, ensuring it sticks securely. Being waterproof, this medical device can be worn all day long.

The wireless 2-by-5-inch Zio patch continuously monitors the patient’s heart rhythm. It stores this data, allowing it to analyze the patient’s heart rhythm later.

This can help because it lets you and your doctor know there are changes in your heart rhythm during the time you wear them.

How Does the Zio Patch Compare To Other Cardiac Monitors?

Most of the time, cardiac monitors include a lot of nodes and wiring. And because of that, some patients may get uncomfortable while using them.

This can lead to changes in results, or the cardiac monitor may produce inaccurate results due to disruption in the signals sent. But with the Zio patch, it is very easy to manage. Therefore, this is a good option for people.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always double-check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.