Human beings always hope the beat goes on especially when it comes to the beating of their heart. Hearts may also beat too fast, too slow or with a funny rhythm. Medical science; being what it is today, many heart problems can be fixed. Fixing and paying are two different subjects though. When shopping for Health Plans it’s always important to pay attention to the major medical portion of the plan. Today all health plans written after September 23, 2010 will not have any yearly or lifetime caps. The Medical Insurance Premiums will be more expensive but you will never “run” out of insurance no matter how ill you may become. However, what you a
ctually pay for a procedure will vary depending on how your plan is structured. A High Deductible Health Plan, or one of the Senior Plans like Medicare Advantage or a Medicare Supplement plan or an HSA will all require different financial contributions from you. How the co insurance is structured will also affect how much money you will need to remove from the ‘ole piggy bank.
Perhaps your heart doesn’t beat as fast as it’s supposed to. The Mayo Clinic says that a pacemaker “is a small device, about the size of a pocket watch, that’s placed under the skin near your heart to help control your heartbeat. People may need a pacemaker for a variety of reasons- mostly due to one of a group of conditions called arrhythmias, in which rhythm is abnormal. Normal aging of the heart may disrupt your heart rate, making it beat too slowly. Heart muscle damage resulting from a heart attack is another common cause of disruptions of your heartbeat. Some medications can affect your heart rate as well. For some, genetic conditions cause an abnormal heart rate. Regardless of the underlying cause of an abnormal heart rate, a pacemaker may fix it.”
So what might one of these little handy devices cost? Blue Cross Blue Shield of Tennessee says that the pacemaker itself would run somewhere between $35,000 and $45,000. The insertion of the pacemaker in an outpatient clinic would be about $2000 and as an inpatient in the hospital would cost about $60,000 So, approximately $105,000 if done in the hospital as an “inpatient” procedure with cost of the device included.
Now, let’s take a look at how the various plans will pay for it. A Medicare Supplement Plan “F” would cover all the costs. You just have to make sure that the health premiums are current. A Blue Cross Blue Shield of Florida Medicare Advantage PPO would cost you $300 a day for the first 5 days in the hospital then would pay the balance of the bill.
Have a high deductible health plan with a $10,000 deductible and then 80/20 in co insurance with a stop loss of $5,000? You would pay the $10,000. Of the remaining $95,000 you would pay $5,000 and your insurance carrier would pay the rest. Your HSA has a $5,000 deductible and no co insurance? Your responsibility would be the $5,000. Hopefully you have been putting money aside in your HSA’s savings account. Any money accumulated in the savings account could be used to pay the deductible.