If you are considered at high risk for certain cardiac events, you may be considering your options for preventive care. When your physician exhausts all other options for correcting a life-threatening ventricular arrhythmia, an implantable cardioverter defibrillator may be the right solution.

An implantable cardioverter defibrillator (ICD) is a battery-powered device that can prevent cardiac arrest and sudden death. The device is placed under your skin and installed through blood vessels. Thin wires connect the device to your heart. Although an ICD can be effective in detecting and correcting abnormal heart rhythm, the American Heart Association recommends that candidates for the procedure meet specific criteria.

 Who will benefit from an ICD?

Sustained ventricular tachycardia or fibrillation refers to abnormal electrical signals in the ventricles that cause the heart to beat faster than normal. Patients with this condition may benefit from an ICD under certain conditions.

What makes you a good candidate for an ICD? You may:

  • Have a life-threatening condition
  • Have ventricular arrhythmia
  • Have survived a heart attack
  • Have been diagnosed with Long QT syndrome
  • Have been diagnosed with Brugada syndrome
  • Have a congenital heart disease

How does it work? The implantable defibrillator delivers an electric shock to correct an abnormal heartbeat. If your heartbeat is too fast, the ICD will send a shock to the heart to slow it to a normal rate. An ICD may have additional features, such as a pacemaker feature that will stimulate the heart or the ability to record heart activity.

Medicare Can Help Cover an ICD

Medicare will cover an implantable automatic defibrillator if you have been diagnosed with heart failure.

Part A Medicare Part A (Hospital Insurance) will cover the procedure to implant an ICD if the surgery takes place in a hospital that accepts Medicare and you have been formally admitted as an inpatient. Part A will include hospital services and supplies including general nursing, semi-private rooms, and meals. If you have Original Medicare, there is a $1,364 deductible for each benefit period.

Part B Medicare Part B (Medical Insurance) will cover the cost of doctor visits and screenings needed to diagnose cardiovascular disease. If your physician determines that you have a medical need for an implantable defibrillator and the surgery takes place in an outpatient setting, Part B will help cover the costs. You will likely pay 20% of the Medicare-approved amount and the Part B deductible applies.

Medigap Many Medicare recipients choose to supplement their Original Medicare benefits by purchasing a Medigap policy. A Medigap, or Medicare Supplement, policy may help cover expenses that Original Medicare does not, such as deductibles, copayments, or coinsurance.

Medicare Advantage (Part C) If you have enrolled in a Medicare Advantage (MA) plan, you will have at least the same benefits as Original Medicare, but many MA plans offer additional benefits. Check with your plan to find out what your exact costs will be regarding your implantable cardioverter defibrillator.

Related articles:

What is Medicare Parts A & B

What is Medigap?

Medicare Part C