CEM/Holters Covered By Insurance?

[skeptic49]

Looks like I may need to go with a CEM (cardiac event monitor) for a month. I've been experiencing what I think are occasional bouts of arrhythmia that are becoming increasingly more debilitating...uncomfortable episodes while walking that included heart palpitations, chest pressure, shortness of breath with more rapid breathing, and fatigue. Sunday evening's episode was much worse than the first one I had because I also broke out into a sweat and lost my color. I had another less severe episode yesterday. My cardio thinks that I'm feeling the arrhythmias more because of worsening AS. So the plan is to identify the type of arrhythmia in order to determine the right therapy. My question is whether insurance companies routinely pay for CEMs or Holters?

Thanks,

Jim

 

[clay_from_nj]

I have Kaiser Permanente, and they did pay for a 48-hour Holter to diagnose my post-surgery PVCs.

 

[escargome]

I was only assigned a Holter for 24 hours but my Blue Cross work insurance paid for it. Hope you can get what you need.

 

[Duffey]

Anthem paid for my 24 hour one five years post-op so I bet you'll be covered.

 

[epstns]

Not that I'm trying to be a skeptic (pun intended), but with worsening symptoms and your shrinking AVA, might it not be time to consult a surgeon?

 

[skeptic49]

Not that I'm trying to be a skeptic (pun intended), but with worsening symptoms and your shrinking AVA, might it not be time to consult a surgeon?

I hear you, Steve...but my numbers are not squarely in the severe range just yet, and so far no syncope, etc. I have confidence in my cardio and I will pull the trigger when the time comes. For now we'll watch and wait and it'll be interesting to see how much longer I can go before surgery.

 

[dick0236]

From your profile, you are now 65 and are, or should be, covered under Medicare. I am also on Medicare and had a 24 hour Holter last summer and Medicare paid a portion of the cost. I think my out-of-pocket for the Holter was $125 ?? I am not sure about a 30 day Holter. I'd call my insurer.

A 30 DAY(?) holter would be a "pain in the ass" for me.

FWIW, I have a Medicare Advantage plan administered by Humana. Love the coverage and costs.

 

[kfay]

Hey Jim, good to see you again! Holter monitors are typically only worn for either 24 or 48 hours, while king of hearts, or event monitors can be worn for a month. I've worn them both for a couple dozen times, and my insurance always pays for them. There is a new monitor, called a Zio I think, and my insurance will not pay for it. The new one is worn for 2 weeks, has one lead, can be worn in the shower, unlike a holter monitor. You can shower with the even monitor though because you replace those sticky things everyday.

Have you ever consulted with a surgeon, Jim?

 

[skeptic49]

Hey Jim, good to see you again! ...
Have you ever consulted with a surgeon, Jim?

Thanks for the info, Kim. Yes, I met with a surgeon who punted me off to one of his cardiologist friends, who I have been seeing for a few years now. They are both university affiliated. We're keeping a close eye on things.

Jim

 

[skeptic49]

Update: I now have this Medicomp, Inc. 30 day CEM...pretty impressive package. Three chest electrodes are connected to a small pendant monitor you wear which in turn connects via Bluetooth wireless to a dedicated smartphone that you also carry or have near you. The pendant device automatically detects arrhythmias and phones them in to a central monitoring facility. My insurance covers the cost. I'm on day three and I have not found it to be much of a bother to deal with. I won't know the results until the end of the 30 days.

 

[Lynlw]

Update: I now have this Medicomp, Inc. 30 day CEM...pretty impressive package. Three chest electrodes are connected to a small pendant monitor you wear which in turn connects via Bluetooth wireless to a dedicated smartphone that you also carry or have near you. The pendant device automatically detects arrhythmias and phones them in to a central monitoring facility. My insurance covers the cost. I'm on day three and I have not found it to be much of a bother to deal with. I won't know the results until the end of the 30 days.

It's amazing how much smaller and better the different monitors are. I'm glad it isnt getting in the way. Let us know how things turn out. BTW are you tired of this weather?

 

[Duffey]

Thanks for updating, Jim. We'll expect a full report at 30 days!:wink2:

 

[skeptic49]

Yes, Lyn...pretty tired of the cold and snow even though it hasn't stopped my walking plan. Mary, I'll report on the results in a month. Thanks!

Jim