Insurance Coverage

As a caregiver or someone with a heart condition, you’re naturally concerned about keeping financial matters under control. No single plan will work for every person or family in this situation, but these pointers are designed to help you get started.

Make sure you and the patient know the details of any health insurance plan(s) that cover their care. Read the fine print to become familiar with such matters as how to get heart device therapies pre-certified and how to submit claims. Most insurers provide coverage for device therapy. If you have questions about whether a proposed therapy is covered, ask the plan’s representative.

Heart devices do not replace medications. Completing the full course of therapy the doctor prescribes is essential for people with a heart condition. If the cost of treatment is an issue, don’t hesitate to explore alternative options and look for assistance. A social worker may be able to provide help or information (ask your doctor or nurse for a referral if necessary). You can also ask the doctor about the Directory of Prescription Drug Patient Assistance Programs, published by the Pharmaceutical Research and Manufacturers of America (PhRMA). This reference book lists drug-donation programs offered by pharmaceutical companies that are designed to help lower-income patients get the medications they need.

Do you need help with the cost of traveling to a medical facility for care? Air Charity Network™ (ACN), formerly Angel Flight America is a not-for-profit, grassroots organization that can help with this expense. Just log on to www.aircharitynetwork.org for further details.

If your loved one is unable to work, take steps as soon as possible to find out what can be done to make up for any loss of family income. If he or she has disability insurance, start applying for benefits. Consider what other financial adjustments may also be needed. Explore your options early on, so you can make proactive choices, rather than having to react to your circumstances.

An additional resource is to inquire with the hospital finance or billing office about special financial programs and options.