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Insurance coverage for cardioversions
I just got my bill for the 2 electrocardioversions I had in December, 2-1/2 weeks apart. The one with the TEE cost just over $4 grand, the one with just the cardioversion, $2 thousand. Is this why the nurse didn't just send me over to get cardioverted, but rather made me wait 6 days? The 2nd time I got in the same day I called. Just wondering what the future looks like on Medicare and a supplementary insurance policy. Will they tell me I can't have a cardioversion because of the cost?
Thanks for your comments and kind words. I need to approach this one day at a time. I am finding myself spending w-a-a-a-a-a-y too much time on afib. It has all but taken over my life. I'm thinking I should put it out of my mind until a crisis arrives (again), but it is really hard to do. I want to be prepared -- my way of perpetuating the illusion that I have some control over all this:P Jerry -- re Medicare -- how depressing!
COMMUNITY LEADER
Yes, the Medicare rate, if accepted, is the biggest part of the coverage. I have seen cases where the Medicare rate was less than 50% of the bill, and my secondary insurance will normally not cover anything over the Medicare approved charges. That is why in 2007 when I underwent open heart surgery I went to a different surgeon than my cardiologist recommended. I went to a surgeon who was "in network" for my secondary insurance (which I believe provides for full coverage once I hit my maximum out-of-pocket, was around $5,000 then). Keep in mind too, Medicare covers only 80% of the approved charges - that's why I have secondary insurance, which now pays only 80% (nothing) until I hit my max. In past years my secondary was 90% after a deductible of $1,200, which was combined with my prescription deductible.
As for 75 yo and over, in the past Medicare had no limits. The sad news/facts are the majority of the medical cost of a human are racked up in their last year or two, a fact not missed by the drafters of the Affordable Care Act, and thus the insertion of a panel to decide what services will be provided for those 75 and over. This is one way to keep Medicare solvent, as you know it is going bankrupt, another is to delay benefits, increase taxes, reduce benefits. The current administrations moves to reduce what doctors are paid is another, and one that will make the waits in Europe look like express service.
As for 75 yo and over, in the past Medicare had no limits. The sad news/facts are the majority of the medical cost of a human are racked up in their last year or two, a fact not missed by the drafters of the Affordable Care Act, and thus the insertion of a panel to decide what services will be provided for those 75 and over. This is one way to keep Medicare solvent, as you know it is going bankrupt, another is to delay benefits, increase taxes, reduce benefits. The current administrations moves to reduce what doctors are paid is another, and one that will make the waits in Europe look like express service.
Yeah, I just about had a heart attack when the bills came in for mine and it was 50 grand. And this is low I am told. I was in and out pretty quickly and afib ablations are a bit more complicated so I can see your concern. I just don't understand why things have to cost so much. It is very sad. I send wishes and prayers your way that the ablation gets approved for you. You deserve an opportunity to try it.
Thanks for the feedback.
Jerry, I am hopeful they won't cut off needed services -- and what is one supposed to after age 75? Are those people expendable? The baby boomers are not going to go for that -- nor should anyone else.
Michelle, the (a little over) $2 thousand included bloodwork they require before the tests, and the anesthesia. Everything was doubled when they did the TEE before the cardioversion. All I have so far is the Medicare statement, not the one from my supplement, and it looks like there are zero unpaid charges by Medicare and around a $200 deductible that will probably fall to me, maybe because it was an outpatient procedure? I will find out when I get my Blue Cross statement what they pay. You are right, usually the doctor/hospital accepts Medicare's payment and it's always a lot less than the hospital bills for it.
This whole thing is worrisome, especially since an ablation may be in my future, maybe more than one. Last I heard, they would pay if you failed 2 drugs first. My EP was saying the ablation should be covered now, but I had the feeling he had an opening in his schedule:) I'm still waiting for my 2nd opinion March 21st. Sigh . . . I am SO tired of trying to figure out what to do, and now (perhaps) if I can afford it!
Jerry, I am hopeful they won't cut off needed services -- and what is one supposed to after age 75? Are those people expendable? The baby boomers are not going to go for that -- nor should anyone else.
Michelle, the (a little over) $2 thousand included bloodwork they require before the tests, and the anesthesia. Everything was doubled when they did the TEE before the cardioversion. All I have so far is the Medicare statement, not the one from my supplement, and it looks like there are zero unpaid charges by Medicare and around a $200 deductible that will probably fall to me, maybe because it was an outpatient procedure? I will find out when I get my Blue Cross statement what they pay. You are right, usually the doctor/hospital accepts Medicare's payment and it's always a lot less than the hospital bills for it.
This whole thing is worrisome, especially since an ablation may be in my future, maybe more than one. Last I heard, they would pay if you failed 2 drugs first. My EP was saying the ablation should be covered now, but I had the feeling he had an opening in his schedule:) I'm still waiting for my 2nd opinion March 21st. Sigh . . . I am SO tired of trying to figure out what to do, and now (perhaps) if I can afford it!
Ok, but seriously, 2 grand to get a couple paddles put on you and the use of a machine they use all the time to produce electricity. Crazy ridiculous in the first place. Health care in the US is just insane. Was the 2 grand what was charged or what was paid by your insurance. Sometimes they jack up the price knowing the insurance co. will slash it to bits.
COMMUNITY LEADER
I have had good services from Medicare over the past 9 years, but the future doesn't look good with the roll out of Obama's Affordable Health Care plan. I have seen limits but only on preventative services and test... diagnostic and treatment are different. For example I just had an echocardiogram less than one year after having my once every two years routine/preventative exam. This recent echo was diagnostic not routine. I do not know if there is a limit on the frequency of electrocardioersions but the bill signed by Obama establishes government case-by-case approval of all "major" activities for people 75 and over. I am not optimistic about what seniors will see in the future. Same goes for the young as private insurance is driven out as benefit as it is currently by many employers . I had health insurance from my employer since 1966, and from the Navy for a few years before that. .
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