New Charge

Hi. I have had a Medtronic pacemaker since Dec 2015. I go to my Cardiologist every six months for a checkup. I see my cardiologist and another Dr takes readout from my Pacemaker. I have Medicare there is a $40 co pay to see the cardiologist no charge for taking the readout form the pacemaker. In between my visits every 90 days I make a transmission with a Medtronic MyCareLink I keep on my bedside table. My last transmit ion was on 14 Nov 2019. In December I got a bill from the cardiologist who read the transmission for $39.10 for a visit. It has never happened before. Has any one else been billed for reading a transmition? This is a first time for me.


4 Comments

You Need A Better Plan

by Swangirl - 2020-02-06 11:48:05

It might not be too late for you to switch from your Advantage Medicare plan to one where you would have no copays, deductibles or surprise bills. Regular Medicare with a Plan F or Plan G supplement covers everything.  You really take chances with an Advantage plan.  If you needed something big like a lead extraction you would end up with your maximum out of pocket expense which is upwards of $6,000 and maybe as much as $10,000.  

Medigap vs Medicare Advantage

by Good Dog - 2020-02-07 15:48:01

I agree with Swangirl, but I can't speak directly to your situation. I have studied Medicare Advantage vs. Medigap Plans where I live. With the average annual amount my wife and I use Medicare annually, my out-of-pocket costs are much less with every Medigap Plan than they would be when compared to Medicare Advantage Plans. Honestly, I don't know why anyone would enroll in a Medicare Advantage Plan. The Advantage plans offer a bunch of extras that you don't get with Medigap, but if you use the plan very much, you pay dearly. Some of the Advantage Plans even offer no or very low monthly costs, but again, if you use it even a reasonable amount on an annual basis, you will end-up paying quite a bit out-of-pocket. Medicare Advantage Plans are great if you have low monthly costs and stay healthy and seldom need any care. Some folks I know swear by Medicare Advantage and love it, but the numbers just don't seem to add up for me.

The cost, availability and coverage of Medicare Advantage plans can vary a lot depending upon your location. Medigap Plans have the same standardized coverage (benefits) for each lettter category. There are only ten Medigap plans available in amost every state. Some states don't offer all ten, but most do. The plans are identified by a letter as Swangirl indicated. i.e. Plan F or Plan G as an example. 

One last thing; I know that trying to compare Medicare Advantage Plans to Medigap can make you google eyed as it can get really confusing. However, it may be worth spending some time investigating your options.

Great Explanation Good Dog

by Swangirl - 2020-02-07 21:41:14

I appreciate the detail from Good Dog.  It's a great description of the difference and why the Medigap plans are better.  When you have health issues it's a type of roulette to go with Advanage plans.  This is why most of the medical providers really marketed the Advantage plans during open enrollment.  They get much more revenue by charging deductibles and copays.  When you see what your out-of-pocket maximum is, you may think you would never incurr that but one major problem could get you there.  

The other issue for me is that you are stuck in your Advantage Plan group and have to take whatever they want to do or not do for you.  With a Medigap policy you can go anywhere that accepts Medicare if you aren't satisfied with the care.  If you need something serious you can go to a big medical center and be fully covered.  You don't need to accept the expertise your group may or not be able to provide for you.  

transmission interpretation bills

by islandgirl - 2020-02-11 17:28:51

My EP bills my insurance quarterly.  I send transmissions once a week and he often downloads other times of the week or month.  Flat fee for him reading it.  Medicare, I can't help you with that yet......  Not sure what he charges, but the copay quarterly is what I pay for an office visit.  

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Member Quotes

In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.