Pacemaker monitoring

In Ireland

by BarryMcC - 2023-03-04 08:43:45

I hadn't considered this costing anything... but in hindsight I guess it makes sense.

Had a Medtronic ICD installed late last year, and monitoring is offered free of charge. I think perhaps they don't offer the same if you just have a pacemaker rather than an ICD, but I feel that's down to the risk profile, rather than cost.

🤷‍♂️

monitoring

by new to pace.... - 2023-03-04 09:29:05

Can not speak for about what happens  in Ireland, but for me in the US it is covered under my Medicare.  The Cardiologist's/ EP's office charges Medicare. 

new to pace

In Canada.....

by Beni - 2023-03-04 10:13:10

Here in Canada, it is the same as Ireland.  Monitoring is free of charge, covered by our single payer universal healthcare system . (Note to others: please do not start hammering me with your views of our healthcare  system - especially if you don't live here.  I am well aware it is not perfect but I am not even faintly interested in debating it.)  Oddly, even with this being the case, the Abbott technician told me many people turn it down.  They feel it is an invasion of their privacy. Me, I just think of it as a safety net.

Here, like Ireland, monitoring is available only for those with a defibrillator,  such as ICDs and, as in my case, CRT-Ds.

I am not much help to you, Im afraid.

Frequency of monitoring

by Gotrhythm - 2023-03-04 14:38:23

My monitoring is paid for through my Medicare suppliment policy. Occasionally I get a notice from the insurance company that $268 for a pacemaker checkup was refused because of some clerical/billing mistake. But I never get a bill from the provider for the amount not paid, so I assume the provider and insurance company work it out between them. I don't know what (ex. office visit, expert analysis) may or may not be included in that amount.

I also have a bedside monitor which downloads data from the pacemaker nightly. I have no idea how that service is billed or who pays it.

Something to consider about the contract you are being offered. I notice there are clinical reveiws monthly. In the US, generally pacemaker checks are done at six month intervals unless there is a problem that needs to be more closely watched. When battery life estimates go below one year, the checks are increased to every three months and sometimes more often.

Bewfore you sign a contract, you might want to get the opinion of a cardiologist about what kind and frequency of monitoring you actuallly need, pariticularly since you have or might have lead issues. 

Home monitoring

by AgentX86 - 2023-03-04 17:38:23

I've never seen a bill for remote monitoring.  I pushed the "button" three times last month and had an in-office interrogation and saw no bill.  Now, the EP did sign off on the interrogation results so there will be a charge for that, usually about $150, IIRC (I'll pay $30). I have an in-office interrogation about every four to six months. 

In short, the monitoring cost has to be built into my EPs charge but they can'd  be burying much. Note that I haven't actually seen this EP in about six years, more than a year before I got the PM.

Pacemaker monitoring

by heatherine008 - 2023-03-04 23:56:25

Thank you all so much for replying.  For some reason I couldn't reply individually.  

@BarryMcC -  thank you for replying.  That's interesting.  I'm Irish also, so at some stage will most likely end up back there and it's good to know what I may be getting into. 

@ new to pace - thank you. 

@ Beni - thank you.  We do have health insurance, but unfortunately I am not covered as it was a pre-existing condition.  We're somewhat stuck with this insurance company now as both my boys have pacemakers which was discoverd on this plan.  It's just one of those things we need to prepare for - especially here in Singapore - my leads may not last much longer (already 23+ yrs) - the surgery to remove & replace them will most likely cost in excess of S$50k+ or more depending on whether there are any complications.   My new pacemaker last year cost S$22k which was done under day surgery.  IMHO, anyone who complains about free health insurance really has no idea!  I had my first 2 pacemakers implanted free whilst living & working in the UK - I couldn't be more grateful!  

@MaryBird - thank you very much for your extensive reply.   Good point on asking what exactly the service is for!  I think in an ideal scenario, I would just like to use the service when I feel something may not be working properly rather than running to the clinic every time I have a concern.  My issue here is not so much the cost for the actual home monitoring (which goes to my clinic), but the cost to register (which I believe is with Medtronics) - I have it for both my boys.  It basically takes 5 minutes to set up, but costs S$1k - just seems a bit steep..  
That's a strange one with your acquaintence, a bit mad he didn't know he was being monitored - my feeling is if they are collecting data from me, that data may at some point be helpful to others - I really don't mind, but can understand why people have an issue if they believe it to be an invasion of privacy.  

@Gotrhythm  - that's interesting - what I'm hearing is that in the US/Ireland/Canada - this service is either subsidised or free.  I've been happy without home monitoring thus far, but I do like it for my boys (one of them had malfunctioning leads and everything needed to be replaced) - but for me, I feel I am generally aware of what's going on - so it's not such a big deal.  However, as my leads are 23+ years old, I think a bit of extra monitoring wouldn't go astray!  Just trying to figure out how much I can debate the S$1k registration fees! 

@ AgentX86  - thank you for responding.  I guess what I'm hearing from you aside of the fact it's covered, is that the fees sound much lower than they are here.   As MaryBird pointed out above, I should ask what they cover as I really only want it in place in case I feel that something is working correctly and then send a transmission. 

Thaks all and have a lovely Sunday! 

Monitoring costs (UK)

by piglet22 - 2023-03-07 10:22:35

In the UK, the home monitor (Medtronics MyCareLink) I have was provided free of charge and arrived through the post.

Although simple to set up many people could find this a daunting process especially going from face to face in-clinic check-ups to totally remote monitoring.

Though expensive, the more sceptical amongst us might think that this is a cost cutting exercise and personally, I have seen the post implantation support go from friendly 6-monthly local checks through to regional annual checks, to none at all.

Various excuses were given like "it's challenging", "the girls find it difficult to transport the equipment".

Disappointing that the hospital didn't provide any guidance on how it worked etc.

What I have found out is that it doesn't any data if things like missed beats start happening.

The first monitor failed in less than one year and involved phoning Medtronics in the Netherlands so there is one monitor gathering dust here because the NHS don't want it back.