If you have a problem getting Medicare, Medicare Advantage, or your health insurance plan to cover an atrial fibrillation treatment, such as an afib medication, catheter ablation, or mini maze surgery, you don’t have to take “no” for an answer. You can push back by requesting a “coverage determination” or submitting an appeal.
To learn how, read: How to Push Back if Medicare or Other Health Insurance Says “No” to Atrial Fibrillation Treatment
“If you have a problem getting Medicare, Medicare Advantage, or your health insurance plan to cover an atrial fibrillation treatment, such as an afib medication, catheter ablation, or mini maze surgery …”
Wait! Whoa! Stop right there!
Why does every health problem have to have a chemical or surgical solution?
Most health problems are caused by lifestyle. Why don’t doctors send more patients for lifestyle training with dietitians, diabetes educators, endocrinologists and exercise therapists, instead of prescribing one-size-fits-all medications?
Jim,
I’ve never heard of insurance denying access to the professionals you mention, and insurance denials is the subject of this post.
No one said that you shouldn’t try these other interventions first. In fact, most of us afibbers try to solve the problem with lifestyle changes FIRST before trying other procedures. It’s when lifestyle changes don’t work, as is usually the case for afib, that we turn to other procedures.
When it comes to afib, dieticians can certainly help, but can you enlighten us as to how exercise therapists can help with afib?
Mellanie
w Dec. 2007 is the first time my heart when into atriial fibrillation. Since that time I have been on medicine, that keeping increasing, a pace maker put in and my cardiact inversion done June 2011. March, August, and Dec. My heart use to go into atrial fibrillation and within 2 to 3 days come back out. Now even with the increase in the medicine it has to be shocked to be straightened out.
Our insurance Perferred Health / Coventry Health Care Plan has denied our approval to have the mini maze surgery. Kansas Medicare is one company that does approve it. Do you know of any companying that do approve this. They say it’s experimental and inverstigational or unproven. But so many surgerys are getting done, do what insurance company is approving it.
Hi Linda, I’m sorry to hear of your struggles with your insurance company. Medicare and most insurance companies do approve of it. A few Blue Cross Blue Shield companies do not, but this is the first we’ve heard about non-approval by Coventry. Generally the surgeon can get it approved – was it the surgeon that received the denial?
Went all the way to top filing for reviews and approval. They would not pay. Had ablation surgery a year ago April. Worked till May of this year and now August another episode.
Not sure about what life style changes Jim you are talking about. We use no caffeine or alcohol, plant an organic garden, raise our own beef with no hormones grass fed. Exercise and stay busy… What else???
Fast foward to 2023 – insurance is STILL denying coverage for the off-pump MAZE procedure and still considers it ‘experimental’. 🙁
L.Valaes,
We have not heard reports of that for years. Please let us know what insurance company is denying that. This procedure has been around for a couple of decades, so is definitely not experimental now.
My husband needs the mini maze surgery we are in Canada. I was trying to find insurance to cover it, as he can’t even get a 1 on 1 consultation. Has anyone found an insurance company that will cover this?
Mina,
Would your national health insurance cover it if done by a cardiothoracic surgeon in Canada?
You might go to https://www.ctsnet.org/surgeons/surgeons-advanced-search and select “Cardiac” as the Subspecialty and put in your province and see what cardiothoracic surgeons are listed.
You might then call some of them to see if they or their colleagues do “Totally-Thoracoscopic Maze (TTM)” or “Minimally-Invasive Surgical Ablation” (those are terms surgeons use for the mini-maze procedure). Perhaps some would be covered by your national insurance.