Type of Surgery

Insurance and the Costs of Cardiac Surgery

Last updated: 04/08/2009

The Costs of Cardiac Surgery
 
Any form of cardiac surgery, regardless of the severity of the medical condition being addressed, should first be considered without any attention to cost. Pinching pennies is a dangerous way to plan your heart operation—it is recommended to first create a list of low-risk, high-benefit procedures, and then weigh the monetary costs within that pool of options afterwards. Nevertheless, everyone wants to know how big of a bill to expect after the operation, because chances are that payments will continue to be a part of the patient’s life for some time.
 
 
Estimating the Costs of Heart Surgery
 
It’s nigh-on impossible to get a set number for your out-of-pocket cardiac surgery expenses. A number of fluctuating factors are responsible for determining how expensive an operation will ultimately end up being. These may include but are certainly not limited to:
 
  • Heart condition
  • Type of surgery
  • Equipment and technology used
  • Medical facilities
  • Location of surgical center
  • Surgeon’s reputation and experience
  • Patient’s medical history, including age, genetic history, weight, lifestyle, and other risk factors
 
The trickiest part about balancing these disparate features is that the way that each one influences your bill will differ. For example, it may seem like common sense that obesity and higher risk—and, therefore, cost—would have a direct relationship, but that may not always be the case, since health and weight are not necessarily correlated. You might also automatically assume that the best and most respected heart surgeons would charge higher fees, but this assumption fails to hold up under scrutiny. False, too, is the idea that the most cutting edge technology and techniques will also cut through your budget the fastest—some innovations in the area of heart surgery are designed to save time and money. 
 
Finally, certain factors will have limiting effects on others. If you need a valve replacement operation, for example, your heart condition naturally narrows the range of surgeries useful to you. Or perhaps you have your mind set on a particular cardiac surgeon that comes highly recommended—but he or she might not be trained in using the type of technology that you’ve also heard so much about. Have a long and careful discussion with your surgeon about each of these factors before making a final decision.
 
Heart Surgery Statistics
 
According to the American Heart Association’s 2009 report on heart disease and stroke statistics, the combined total cost of all cardiovascular disease in the US was $475.3 billion. This staggering sum includes both direct and indirect causes, and can be broken up into several categories. 
 
The same report lists the average hospital charge for coronary artery bypass grafts as $99,743 in 2006. Pacemaker surgeries came in at $47,081, with innovative PCI (percutaneous coronary inhibition) procedures averaging $48,399 per operation. Diagnostic cardiac catherization surgery was on the lower end of the scale at $28,835, but valve surgeries were the most costly at $141,120, on average.
 
Insurance and the Costs of Cardiac Surgery
 
If the numbers seem high, don’t be scared away too quickly. The average hospital costs, as provided by the American Heart Association, fail to take insurance into account. Most patients receive some sort of either full or partial healthcare coverage; heart surgeries are, after all, medical necessities that cannot be ignored. Speak to your provider for the best estimate of how much out-of-pocket expenses to expect after deductions have been made.
Even for the uninsured, there are options aplenty to whittle down the cost of your cardiac surgery. American Medical Outsourcing (AMO) is an organization that seeks to reduce the expenses for uninsured Americans. Through a group such as this one, or even by contacting a surgeon and negotiating fees directly, you can cut down on the cost of cardiac surgery without putting your health in jeopardy. 
 


Last Updated: 04/08/2009

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