Follow-up After Recovered

[Erin]

Dr. Fett, we discussed in another thread that it would be a good idea for me to have another echo, as it has been a year since my last echo. I'm trying to be frugal financially, and I think my new insurance may treat my PPCM as a pre-existing condition and may not cover costs of tests or related office visits. So...I'm trying to avoid incurring any unnecessary expenses.

My former cardiologist doesn't think I need any more follow-up attention, but I would like to at least have another echo, since my new PCP (I've moved to another state) is interested in me having one as well.

My question is this: do I need additional work-up, i.e., ECG, labs, etc.? Because my PCP wants to have me consult with a new cardiologist, and the new cardiologist wants me to have every test BUT the echo and then consult with me re: whether or not I even need an echo!?

I've been conversing with my PCP's nurse (who is acting as go-between) and have requested that my PCP only put in orders for an echo, but the PCP wants me to bring him a copy of my medical record from the cardiologist before he decides to do that or not.

If it is best that I get all the tests done, I'll do it, but I'm really unsure since my last cardiologist seems to think I don't need anything at all. I would really appreciate your opinion.

Thank you.

[SerenaWelsh]

quick question, Erin:

Did you have continuous insurance coverage and just change companies, or was there a period where you had no coverage in between?

Hoping for a great big 65% when/if you get one soon!

[Erin]

To hear 65% would be awesome.

I've had continuous coverage and am in the process of changing companies.

[JAMESFETT]

It is better to be sure about what your insurance will cover, and it is better to follow the advice of your physician, who knows all the details. From the sketchy info that I have, it seems to me the only essential test is the quick look echo to know what your current LV EF is.

JD

[Erin]

Okay, thanks, Dr. Fett. My new PCP really has no details, so maybe the first thing I need to do is give him a copy of my medical records tomorrow as I planned. I don't have any arrythmias, only trace mitral valve regurgitation as per a year ago, 55% EF a year ago after three months off med's, and the medical records from my cardiologist say, "Conclusion: PPCM resolved, follow-up on p.r.n. basis," and it says he thinks this is a "done deal." (Which made me smile to read.)

I don't know if that helps clear up the sketchiness...

I'm waiting to hear what the terms of my new insurance are. I'm changing to independent Blue Cross Blue Shield (BCBS) until my husband finds new work here, or I have the choice to remain on COBRA, which is about a $400 a month difference in price for us. We were accepted by BCBS, but have not received the contract yet for our review and acceptance, but in their acceptance letter, an exclusion for pre-existing condition was mentioned, which I assume means -- me.

If I knew what the cost of an echo and interpretation would cost, I might decide to stay on COBRA?

Thanks again, Dr. Fett.

[mom2gageandkeely]

Just butting in here to gove you my experience.

My husband lost his job many moons ago and was given a sevrance package which included insurance paid for 6 weeks. I contatced insurance companies and most all I found that were independant considered ppcm as existing. We opted to pay cobra ( even though it hurt at 800 a month way back then) and that way I was not pre existing and when he found another job and insurance it picked right back up. I made all the calls at the time and that is what I dealt with.

I *think* echo's are about 800 out of pocket- anyone correct me if wrong.

[SerenaWelsh]

Erin, I *think* that as long as you've had continuous coverage, they can't treat it as pre-existing. Of course, you should check with the new company first...but that's the way I understand these things to work.

Good luck! :D

[Erin]

Thanks, Jen and Serena. I think my PCP and I will have to be patient until I get the new insurance co.'s contract and can read it to see what it includes or excludes. If an echo costs $800 or more alone (whew!), then we'll have to do the math to see what the best course will be depending.

Maybe I'll have to wait until DH gets group insurance with a new job. That could be up to six months though, since you never know.

All these decisions!? :o

[Erin]

Oh, wait, how does that work? Does that mean if I accept an independent insurance with an exclusion or pre-existing clause, it could affect my coverage if I change to group or another independent insurance for the rest of your life? Holy cow.

I'll definitely call the DOI (didn't even know that existed) and check into it.

Any more you can tell me about that would be of interest to me, thanks!