Pacemaker Club: Two pacemakers in the space of 4 months.

Two pacemakers in the space of 4 months.

by rwhite1322
2017-01-19 11:59:37
ICDs
1605 views
3 comments

Hi. I was wondering if any of you have had this experience. On October 4th of 2016, I had a new PM implanted to correct a condtion called dysynchrony which means that, as a result of HCM surgery back in 2009, my heart chambers were not beating in synchronization. A biventricular PM was implanted to correct this condition. 3 months later (last week) I went in for my first checkup after the biventricular PM was implanted. The doctor now says I need an ICD PM instead because now my ventricles are occasionally beating really fast which puts me at risk for severe cardiac arrest.

My question is this...my insurance runs from October to October. My biventricular PM was implanted just after my insurance began a new coverage period. Does anyone know if insurance will cover a second PM within a single insurance coverage year?

3 Comments

Insurance in USA

by Grateful Heart - 2017-01-19 13:44:08

Your doctor will provide documentation to the insurance company showing the upgrade to a bi-vent with a defib (CRT-D) is "medically necessary."

Sorry this wasn't picked up sooner though....so you could avoid a second surgery so soon.

Hopefully, you have seen improvement since your bi-vent was implanted. I've had a CRT-D for 8 years now. These are amazing devices.

Grateful Heart

second opinion

by Tracey_E - 2017-01-19 15:39:06

As Grateful Heart said, if your doctor can support it then there shouldn't be a problem getting insurance to cover it, however you'll want to check and recheck that before surgery!

Also, you might want to consider a second opinion before having another surgery, get new eyes to see if you do in fact need another upgrade and why you weren't given the upgraded one in the first place. Three upgrades so soon is highly unusual.

2 in 4 months

by Salt - 2017-03-18 07:56:18

Hi, You have probably settled this by now, but just wanted to say that I had a pacemaker implanted in December one year, and "upgraded" to an ICD the next April. No problem with insurance, and it is great to have the peace of mind of the ICD. Best of luck!