What Are Your Rights?
At the moment, there are no acts or laws in place to ensure that the 83 million U.S. adults who are suffering from heart disease receive help with their treatment.
What Problems Might You Run Into?
“Almost all of the tests currently used to check heart function are seen as necessary by insurance companies,” says Dr. Nieca Goldberg, a cardiologist and medical director of the Joan H. Tisch Center for Women’s Health in New York. “There aren’t really any of the standard tests that you’d have trouble getting covered.” But she did caution about some of the newer scans available. “Something like the latest CT scan, which looks for plaque in arteries, might not be guaranteed coverage and could cost $500 or $600,” she says. “Don’t think you need to get a procedure done just because it’s available and brand new. Definitely talk to your doctor and insurance company first so you aren’t saddled with a bill you can’t pay.”
How Can You Save Money on Treatment?
Having heart disease can end up costing you a lot of money. According to the American Heart Association, a 2009 survey found that more than half of people suffering from heart disease had difficulties paying for all of their treatment, even if they had health insurance. And 46 percent of those who had a hard time financially delayed getting recommended care.
One way you can improve your heart health is to make lifestyle changes—stop smoking, eat healthier, exercise more. And these are things that won’t necessarily cost a lot of money. “It’s expensive to meet one-on-one with a nutritionist, so look into doing a group program like Weight Watchers,” Dr. Goldberg says. “Or see if the hospital you’ve gone to has nutritionists on staff. That type of service won’t be covered by insurance typically, but going to a hospital nutritionist instead of one in private practice will cut down on costs.” As for exercising, walking is a great way to get moving. To make sticking with your workout regimen easier, the American Heart Association has a program called My Walking Club that pairs you up with other walkers in your area. Visit mywalkingclub.org to either start a club of your own or join an existing one.
A major part of treatment costs for heart disease are the prescriptions you’ll be put on—a combination of anticoagulants, aspirin, ACE inhibitors, beta blockers, and more—which can become very expensive. “Antiplatelet medicines like Plavix are brand name and there aren’t really generic options yet, keeping their price high,” Dr. Goldberg says. “But both cholesterol-lowering drugs and blood pressure medications are available in generic forms, so you’ll likely be able to save money there.” She says to make sure to shop around since these are often drugs you’re going to be on for a long time, if not forever. “Do price comparisons and see what CVS, Walgreens, even Costco would charge,” she says. If there’s no option besides a name brand, high-priced drug, look into the Partnership for Prescription Assistance (pparx.org). The program has teamed up with most major pharmaceutical companies to offer discounted medication to those who can prove their income is below a certain level.