Micra pacemaker covered by Blue Cross Blue Shield

Blue Cross

by AgentX86 - 2020-02-24 16:15:23

I don't know why it wouldn't be covered, now that the Micra has FDA approval but Blue Cross is a company that sells many insurance policies. In fact, it's not just one company. Anything is possible.

if

by ROBO Pop - 2020-02-24 17:17:12

If your doctor is recommending one he can check with your insurance and advise. It's not just selecting s device, insurers want medical proof you need one and it is the best option for your circumstance

Some lead pacemakers are MRI friendly

by cagedliberty - 2020-02-24 18:00:25

Hi!

i had the same issue as you and was implanted with a St. Jude Medical pacemaker in December 2019. My pacemaker medical card says that it is a MRI conditional system. Here is the information about the pacemaker on their site: 

MRI READY

The Assurity MRI pacemaker and Tendril MRI™ lead are designed specifically to allow full-body, 1.5T MRI scans** that meet certain scan conditions.

Meets industry-standard MRI testing requirements

Capable of full body 1.5T MRI imaging scans

SJM MRI Activator™ handheld device helps reduce required steps before and after scanning, resulting in more efficient workflow than conventional MRI pacemakers

So if your only concern is the MRI, it shouldn't be an issue with a MRI friendly pacemaker.

Call your insurance

by cagedliberty - 2020-02-24 19:06:54

I would suggest calling the helpline on the back of your insurance card. They will know your policy coverage and would be be best able to guide you on whether a leadless pacemaker is covered. 
Alternatively,you can call the office of the doctor who recommended the pacemaker and see if they can talk to the insurance company for you. Some of my doctors have really helpful staff who have chased up insurance for me (I also have BCBS).
 

Talk to your Doc

by nhorner10 - 2020-02-24 19:45:44

I too was very interested in the Micra before I had my PM placed last August - I'm an active 24 year old and the the Micra, being leadless and all around less noticeable, was a very attractive choice. However, as I understand it the Micra is primarily used to correct AV node synchrony while bradycardia is often a SA node problem (I've attached a link below for more info, it does a better job of explaining the difference between the two nodes than I could). I was having epilepsy induced cardiac arrest so the Micra wouldn't have done much for me since the SA node wasn't even getting a signal to transmit to the AV node (essentially my brain stops telling my heart to beat). Maybe you already have, but it's definitely a conversation to have with your doctor as I am not one!

I ended up getting a Medtronic Azure which is also MRI safe (I've already had 2 MRIs since getting it, no problem). It also is bluetooth enabled so it connects to your phone and you don't have to have a seperate monitor for it. Unfortunately I can't comment on the insurance side of things but I hope I was able to help at least some!

https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=sts14215&lang=en-ca

https://www.thoughtco.com/heart-nodes-anatomy-373242

NEWS FLASH

by ROBO Pop - 2020-02-25 11:59:48

All pacemakers and defibrillators are MRI compatible. The Radiologist just has to follow the proper protocol.

News Flash

by AgentX86 - 2020-02-25 13:13:48

All recent pacemakers are MRI compatible but you'll still play hell getting an MRI. You can't go to a doc-in-a-box to get one and have to go to a major hospital (big $$ for those who care about such things). Even then, radiologists want no part of you and will make you jump through many hoops before they'll do it. The wallet card the manufacturer gives you is useless. After a month of paperwork and involving three hospitals (the one I was admitted to after the ambulance ride, refused) and getting approvals, I finally got the MRI. The technicians knew exactly what to do (no big deal) and I was in and out in a half hour but it was a month of BS before I could get to that half hour. So, yes, all (recent) pacemakers and leads are "MRI compatible, it's still not automatic).

Edit: There is no reason to believe a Micra would be any different.

news flash...

by ROBO Pop - 2020-02-27 16:54:49

If 'd meant "recent" I would have said that.

Fact is any competent Radiology lab has protocols for performing MRI's on any (meaning old and new) pacemakers, defibrillators and CRT''s

"MRI compatible" is just a marketing tool for idiots

Irrelevant

by nhorner10 - 2020-02-28 13:09:00

Regardless of the validity of that claim, AgentX is right. Most doc-in-the-box facilities don't even have the means to perform a MRI on a PM recipient beacuse they don't have the programing equipment from the PM company - you have to have the settings adjusted before/after the MRI, similar to getting your routine interrogation. Most major hospitals that do have the programming equipment WILL NOT perform an MRI on a PM patient unless it is officially MRI-conditional, presumably because of insurance, liability, and potential safety risks. I know there have been some medical studies done that suggest all PMs are MRI safe, but that doesn't mean much since it's near impossible for the average-joe to actually get one in the US if it's not deemed MRI-conditional.

Calling people idiots for believing what their doctors tell them doesn't seem like a very productive comment in a support forum