Medicare and Medicaid Coverage

• by Dory the Blue Fish
• 2011-04-19 02:04:33
• ICDs
• 3288 views
• 0 comments

I believe whether Medicaid covers the ICD implant and surgery depends on the state where you live. Medicaid coverage is harder to come by nowadays.

I do know that Medicare covers an ICD implant. Medicare has paid for my last two devices.

My first implant was in October 2000, and it was paid for by my group insurance where I worked. An electrophysiologist diagnosed me with life-threatening arrhythmia along with an ejection fraction of less than 25% (CHS). I had many cardiac arrests that required shock therapy from my device. (Cardiac arrest results from irregular heartbeats as well as bradycardia.)

I filed for SS Disability in 2002. I was approved about 18 months later. Before I was approved for Medicare, I was on Medicaid for my state, which is called TennCare.

I don't know whether TN Medicaid would have approved a second implant. By the time I needed another, Medicare had approved me for disability.

Because my income is so low, I qualify for dual coverage. I am covered by both Medicare and Medicaid. I have not paid one cent for any of my three defibrillator/pacemaker implants.

Have you seen an electrophysiologist? Have you worn a Holter monitor? Have you had an ejection fraction test?

Have you asked for help from your Department of Human Services (or Social Services)?

Focus on qualifying for disability first. Go to a SS Disability lawyer since usually you get turned down the first time.

Regards,
Dorothy

It is harder to be approved for Medicaid in many states nowadays because of budget constraints.