Is Pacemaker Covered By Insurance In India?

The insertion of a small electronic device into the patient’s chest to regulate the irregular cardiac rhythm is the goal of this medical operation. It keeps the heartbeat from falling to dangerously low levels. People with arrhythmia, or an irregular heartbeat, would need to have a pacemaker implanted. In India, the cost of a pacemaker ranges from roughly Rs 45,000 to as much as Rs 3 lakh.

Are pacemakers covered by insurance in India?

Cardiac health insurance plans cover the implantation of a permanent cardiac pacemaker if it is needed to treat a significant cardiac arrhythmia that cannot be addressed otherwise. A medical specialist must approve the insertion of the cardiac pacemaker.

Are pacemakers covered by insurance?

Cardiac pacemakers will be covered as a prosthetic device by the Centers for Medicare and Medicaid Services. To treat a person’s heart problem, they must be medically essential.

Medicare has four sections that may help cover the cost of a pacemaker. The parts that follow will delve deeper into these topics.

Part A

A person’s inpatient hospital care is covered by Part A. Because the operation to implant a pacemaker is frequently performed in a hospital, Part A would pay qualified expenditures.

Because Medicare Advantage plans must provide the same Part A benefits as Original Medicare, they would also reimburse qualified expenses.

Individuals must pay some out-of-pocket fees under Part A, such as the benefit period deductible, which in 2021 is $1,484. The benefit period begins the day a person is admitted to a hospital. This term will come to an end once they have been out of the hospital for 60 days in a row.

Part B

Part B of Medicare covers outpatient medical treatment and can assist cover the expense of doctor visits, such as if the pacemaker needs to be adjusted outside of the hospital.

In most cases, a coinsurance of 20% of qualified outpatient expenditures is required in addition to a monthly premium. The normal premium for 2021 is $148.50.

The amount of Part B premium a person pays is determined by their income as reported to the Internal Revenue Service two years prior. This means that a person’s premium in 2021 will differ based on their stated income in 2019.

Part C (Medicare Advantage)

The benefits of traditional Medicare sections A and B are combined in Medicare Advantage plans, therefore pacemaker coverage follows the same benefit regulations.

Medicare Advantage plans are administered by private insurance firms, and they frequently provide extra benefits such as dental and optical care.

Premiums for Medicare Advantage plans vary depending on the insurance carrier, the plan, and the person’s region. Out-of-pocket costs may differ, and plans may charge extra if a consumer visits a provider who is not in their network.

Part D

Medicare Part D programs, which are prescription medication coverage, are also administered by private insurance firms.

The cost of prescribed drugs connected with pacemakers is normally covered by Part D plans.

Out-of-pocket costs vary by plan provider, location, and plan type, just as they do with Medicare Advantage plans.

What is the cost of pacemaker surgery in India?

In India, pacemaker surgery typically costs between Rs. 2,75,000 and Rs. 3,00,000. The device ranges in price from Rs.45,000 to Rs.1,50,000. The prices, however, may vary depending on the hospitals in each city.

In Hyderabad, pacemaker operation costs start at Rs.52,200. However, it is dependent on a number of things.

Types Of Pacemaker Surgery

Only one lead wire links the Pulse Generator to one chamber of the heart in a single chamber pacemaker implant. It’s usually reserved for patients who solely need pacing support for their right ventricle.

Dual Chamber Pacemaker Implantation: Two lead wires connect the Pulse Generator to two heart chambers in this procedure. It normally connects the right atrium and right ventricle to the Pulse Generator, which aids in the coordination of both chambers’ contractions. It also ensures that both chambers’ contraction and relaxation occur at the same time.

How much does a pacemaker cost without insurance?

  • Medicare or private health insurance may cover pacemakers. The Dartmouth-Hitchcock Medical Center in New Hampshire estimates an out-of-pocket cost of $2,604 for Medicare enrollees, including deductibles and coinsurance. Private insurance patients should anticipate to pay around $4,400.
  • According to the National Heart, Lung, and Blood Institute, implanting a pacemaker is considered minor surgery. After numbing the area where the pacemaker will be implanted, a doctor will thread the wires via veins and into the proper place. He or she will then sew up a small cut in the breast or abdomen and implant the device through it. The surgery is expected to take a few hours, according to the institute.
  • This Mayo Clinic illustration depicts the placement of an implantable defibrillator in the body, while this drawing depicts the placement of a pacemaker.
  • According to Blue Cross Blue Shield of Tennessee, the cost of pacemaker surgery varies greatly depending on whether it is performed as an inpatient or outpatient treatment.
  • Extended hospital stays might cost anything from $20,000 to $65,000 per day or more. The average daily hospital fee in Wisconsin is $23,695, with an average hospital stay of around six days, according to PricePoint.
  • Uninsured/cash-paying patients may be eligible for discounts at several hospitals and orthopedic specialists. For example, Washington Hospital Healthcare System in California offers uninsured patients a 35 percent discount as well as a financial help program for those who qualify.
  • The Pacemaker Club offers a number of tools for patients who are getting a pacemaker, such as discussion boards and advice on where to find doctors around the country.
  • A pacemaker cannot keep a failing heart beating, and roughly 20% of patients who have pacemakers receive agonizing shocks in their final weeks of life. Information about end-of-life planning is available from the Heart Rhythm Society.

Why are pacemakers so expensive?

According to a study published in Circulation: Journal of the American Heart Association, more expensive pacemakers that “pace” the heart’s upper and lower chambers are worth the extra cost since they can lessen the risk of hospitalization and impairment in individuals with heart disease.

Transvenous implantation

The cardiologist will create a 5 to 6cm (approximately 2 inch) cut just below your collarbone, generally on the left side of your chest, and insert the pacemaker wires (pacing leads) into a vein during transvenous implantation.

X-ray images are used to guide the pacing leads along the vein and into the correct chamber of your heart. They subsequently become trapped in your heart’s tissue.

The pacemaker is attached to the other ends of the leads, which are inserted into a small pocket made by your cardiologist between your upper chest skin and your chest muscle.

Transvenous implantation is done using a local anesthetic that is administered as an injection.

The region where the cuts will be performed will be numbed, but you will remain awake throughout the surgery.

When the cardiologist injects the local anaesthetic, you’ll experience a burning or prickling feeling at first.

Although the area will quickly go numb, you may experience a pulling feeling throughout the procedure.

A small tube called an intravenous (IV) line will be placed to one of your veins prior to the treatment.

To keep you relaxed during the treatment, you will be given sleepy medication through your IV line.

The process normally takes about an hour, but it could take longer if you’re also getting a biventricular pacemaker with three leads or additional cardiac surgery.

After the procedure, you’ll normally have to stay in the hospital overnight and recuperate for a day.

Epicardial implantation

Epicardial implantation is a less common and alternate form of pacemaker placement.

A cut in your belly, below the chest, is used to join the pacing line or leads to the outer surface of your heart (epicardium).

Children and people who are having heart surgery at the same time as a pacemaker are often candidates for epicardial implantation.

You’ll be unconscious throughout the surgery because it’s done under general anaesthesia.

The tip of the pacing lead will be linked to your heart, and the other end will be attached to the pacemaker box by the surgeon. This is frequently inserted into a pocket under your skin in your abdomen.

The treatment takes between one and two hours on average, although it may take longer if you’re undergoing additional heart surgery at the same time.

Recovery time is usually longer after epicardial implantation than after transvenous implantation.

Implantable cardioverter defibrillators (ICDs)

Implantable cardioverter defibrillators (ICDs) are usually implanted transvenously, or through a vein. They can, however, be worn beneath the skin (subcutaneously).

General anaesthesia or local anaesthesia and drowsiness are used to perform subcutaneous implantation.

The ICD will be placed in a pocket made in the left side of the chest during the procedure.

The pacing lead and electrodes are also attached to the device and implanted under the skin along the breast bone.

The ICD’s sensing, pacing, and recording functions will be checked and adjusted when the cuts are closed.

Depending on the type of ICD you have, the procedure can take anywhere from one to three hours.

How serious is needing a pacemaker?

You may need a pacemaker if you have bradycardia, sick sinus syndrome, or another illness that changes the way your heart beats. If you use medications that slow your heart beat, you may need a pacemaker.

How long is recovery from pacemaker surgery?

For the next 4 to 6 weeks, avoid reaching up on the side where your operation was performed. That means, for example, not hanging clothes out to dry or lifting anything from a high shelf.

However, to avoid a frozen shoulder, it’s critical to keep your arm flexible by gently moving it. You can learn how to do this from a physiotherapist.

After around four weeks, you should be able to accomplish all you desire.

The amount of time you’ll require off work will be determined by your position. Your cardiologist should be able to help you with this.

People who have had a pacemaker implanted are typically recommended to take 3 to 7 days off work.

People who work as drivers, such as bus and truck drivers, will be prohibited from operating these vehicles for six weeks after the pacemaker is implanted.

Which company pacemaker is best?

Osypka Medical is a Swiss firm that is one of the oldest in the market for cardiac pacemaker devices. It has succeeded in developing the most advanced cardiac equipment, making it the most dependable brand on the international scene.