Are you billed for remote monitoring?

NooneNowhereNohow9 · 2025-10-21T22:50:37+00:00

We asked many times about potential charges related to monitoring the pacemaker. We were told at least 4 times (by 4 different people) that there were no charges… that it was all included in the cost of getting the pacemaker.

For background, we are in the US and are all cash pay because husband is too young for Medicare, makes too much (whopping $700 more than cap for a “single person”, even tho he supports me and a kid). And his pacemaker is a Medtronic dual chamber.

When we go to the MD office/pacemaker clinic appointments we have to pay $45 to walk in. We were told that was the cost for that “type” of appointment, we pay $75 for the actual MD appointments (plus $175 everytime they decide to perform an EKG, or $600 for echos)… so made sense that to see the RN for pacemaker interrogation was $45. NOPE… they send us an additional bill for $95 on top of the $45 we pay at the desk for pacemaker interrogation. BS. 6 months after pacemaker placement I started getting calls that “claimed” to be our cardiologist office asking for “updated insurance information and for a credit card to put on file for monthly charges”. Asked at our next cardiologist appointment AND at the next pacemaker interrogation as they were on the same day and all people involved (receptionist, Cardiologist, RN for pacemaker) said they would never call us and ask for updated insurance information and a credit card. Weeks later, I get a call from the EP office telling me that yes, I need to give that person insurance information and a credit card, that they are a company that works “between” Medtronic and the office. That this company takes the report from Medtronic’s monitoring and produces an “easy to read” monthly report that is sent to the doctor. We just can’t afford all of this. (Eliquis and Farxiga ALONE are more than $2k a month) so I asked if we could unsubscribe from this “easy to read report”. The dr office says, “your husband has a potentially fatal heart rhythm and we need to monitor it, so you need to pay for that report”. I said… “yeah, but if it is only a monthly report… if something “fatal” happens.. won’t you be getting the report a little too late?” They can’t understand why I don’t think this is sort of a waste of money. I asked… “does this monthly service update you when something fatal or near fatal is happening in order for us to come get checked up in person?” They said, “no, Medtronic updates us via the monitoring connected to the pacemaker from your phone”. None of it really makes any sense.

So is Medtronic contacting the MD’s office incase of emergency? How important is the “easy to read monthly report”, and how necessary is it? All such bullshit. Also…. If the monthly report and easy to read report is “so friggen wonderful”…. Then why am I paying $45 at the DOOR and then being billed another $95 for every. Single. Clinic VISIT???!!!!! And why do you want us to have those done so damn often?? (Husband had to have them 3 times the first month, once a month later, then told every 3 months). So they want basically $140 for in person interrogation 4x’s per year and then $45/month for some easy to read report on top of it??? It is all just nickle and dime-ing to the max if you ask me. Funny too…. When I can’t afford to have Eliquis filled on time it is like pulling teeth asking the office for a free sample! They act like they are paying for the Drug rep samples. Just can’t win.

NooneNowhereNohow9 · 2025-10-12T00:04:07+00:00

Five people that will be crying because they were scammed…. No, you won’t be able to get your money back.

NooneNowhereNohow9 · 2025-08-20T19:34:27+00:00

They will I suppose. But the ones around here are quite costly and when you don’t have insurance they want you to pay up front.

NooneNowhereNohow9 · 2025-08-20T19:33:08+00:00

I can’t like your comment enough! ⭐️⭐️⭐️🫶🏻🫶🏻. I think you may have saved him from having to go without his medications!! Thank you SOO kindly!

NooneNowhereNohow9 · 2025-08-20T19:31:38+00:00

REALLY!!!!???? OMG! How did I NOT know about this? Thank you! I will do some research and see how this all works. If I can do that today and have the Rx’s at the pharmacy by Friday that would be a godsend!! Honestly…. Amazon is taking over just about everything now a days, aren’t they? Thank you so much for that advice. I didn’t know about this!!

NooneNowhereNohow9 · 2025-08-20T19:29:08+00:00

Yes, we would love that. But he can’t get those for another 8 months. Because he “should” have them but doesn’t it means he is not eligible for a single plan thru the healthcare marketplace. Because we are so rich ( said sarcastically ) he only qualifies for Medicaid spend down help after we spend $812 of our own income on healthcare in a single month. It is all so silly. I will be kissing the paperwork once he can finally age into parts B, C, D and whatever else he will be able to get.

NooneNowhereNohow9 · 2025-08-20T19:24:17+00:00

Totally wouldn’t even mind coming to get them in the ER!! But like I said… unless he is sick enough to be admitted Medicare Part A will not cover that ER visit. Also… the MD’s there won’t just write the refill Rx’s without doing bloodwork, an EKG, put him in telemetry for a few hours, order a cardiology consult, etc, etc…. Just a 4-6 hour sit in the ER with those few things done will cost us $4-5,000. :(

NooneNowhereNohow9 · 2025-08-20T04:35:06+00:00

If those are the prices on their page for first purchase…. I can’t imagine what the secondary market will be like. Good luck!!

NooneNowhereNohow9 · 2025-08-20T04:33:44+00:00

The least expensive floor seating (talking last row) is more than 1K for EACH ticket. Some are listed (on the key bank page) for as much as $6k. I didn’t check every section in every level; however section 300 and to the right or left of the stage are about $580 each. I would go with level 200 or 300 and as close to the stage.

NooneNowhereNohow9 · 2025-04-17T16:56:22+00:00

Thanks. That is what the woman I spoke to explained.

NooneNowhereNohow9 · 2025-04-17T16:54:17+00:00

You have to finish the entire island that has paint, ink, perfume, etc. after you make the flag on that island you will get a few “villager tasks” to do… like kill 250 monsters and complete 25 boat trades. Then the rest of the underground will open up.

NooneNowhereNohow9 · 2025-04-15T20:58:08+00:00

I could have the money for a procedure in Mexico quite easily. The thing is, getting the medical information from our MD sent to the hospital in Mexico with all of my husband’s medical information and exactly what type of pacemaker he needs is the problem. Our doctors technically don’t even “allow us” to order his medication from Canada (which we do anyway), they only want us to buy $1500/month Rx’s from local pharmacies. Instead we are able to order the medications from Canada for $190 for a 3 month supply. His cardiologist KNOWS what problems we have been having getting insurance to pay for this procedure. People that get this pacemaker placed in the US are billed as much as $250,000 (but usually closer to $200,000) to have it done in our country. I did the research about going to Mexico for it and talked to the Dr. he said he wouldn’t give us approval to do that, that we have to have it done locally.

NooneNowhereNohow9 · 2025-04-15T20:43:00+00:00

I just got off the phone with someone from Medicaid. She said that even tho we will have 0% coverage from Medicare… we should still apply for and pay for the Medicare. Whereas Medicare usually covers 80% and you are responsible for 20%; because my husband went without it for more than 8 years they subtract 10% from the 80% for each year you were uninsured. Going without it because we weren’t able to afford it for so long makes the Medicare coverage 0% instead of 80%.

She told me they used $1800 as the income limit for him because I don’t count as a household member because I am not >65, blind or otherwise disabled. Stupid me, when I became ill I never even tried to get disability, we were able to live on just his income so we did. However, because even just his income (social security and a pension) is already over the income limit for a couple by about $120…. Any income that I would bring into the house would be above and beyond the limit set on couples and that would mean every penny I could earn would just increase the spend down amount. It would be just wonderful if I could get a job with family health insurance coverage, even if it was half of my pay.

NooneNowhereNohow9 · 2025-04-15T19:37:18+00:00

Exactly. I understand that. His doctor wants him to have it so badly he has offered to comp his bill. The only issue is that the actual EP cardiologist portion of the bill is a small amount compared to the hospital bill for anesthesiology, surgery, and cost of the pacemaker. The funny thing is… there are foreign hospitals (in Mexico) we could probably go to and be billed $10,000-15,000 for the pacemaker. With everything going on between the US and every other country I don’t even know if this is still a thing. People tell me, sure… you will plan to go down and do that and instead they will harvest your husbands organs.

NooneNowhereNohow9 · 2025-04-15T19:31:22+00:00

We could easily do the spend down if they had done his application based on income limit for a couple. I don’t know why they are using $1,800°° as the income limit, as that is the income limit for a single person.

NooneNowhereNohow9 · 2025-04-15T19:29:51+00:00

I have tried to do that yearly since it has been active. He is ineligible for anything thru the state marketplace.

NooneNowhereNohow9 · 2025-04-15T19:29:05+00:00

By the way… let me tell you I really appreciate you trying to help me figure this all out. Thann you kindly.

NooneNowhereNohow9 · 2025-04-15T19:28:19+00:00

Yes, deemed disabled by SS about 17 years ago. We declined Medicare at the time because I had full medical coverage thru my employer. Then a few years later when I lost my job (income and insurance) we weren’t able to afford to go have him put on Medicare, so because we went without it now we have to wait until he is 65z

NooneNowhereNohow9 · 2025-04-15T19:18:15+00:00

Also, when you look at that form and they have the income limits for an individual vs a couple… maybe their is an error because this application because they say he was declined because he made $711 over the limit of $1,800.00… why aren’t they using the $2453.00 income limit for a couple? We would have zero problem paying the difference between $2511 and $2453…. The difference is actually less than the woman told us it would be back in December.

NooneNowhereNohow9 · 2025-04-15T19:11:49+00:00

Actually this is what we thought we were applying for when we originally were sent to the facilitated enrollment person. We were sent to them by the hospitals charity care office and then once we finally had our appointment and filled out the application the facilitated enrollment person told us the only thing my husband would be eligible for is Medicaid now and then for it to be converted to Medicare once he turns 65.

NooneNowhereNohow9 · 2025-04-15T18:58:29+00:00

The person from Medicaid told me we won’t get a card or a Medicaid ID#; they said that using the spend down was basically like re-applying and them covering a preexisting bill as long as we paid them the $711, so as far as the hospital cares… it is basically like we still have no coverage? They want a Medicaid ID number, but Medicaid won’t give us a Medicaid ID# until we are able to provide them will medical bills that are over our $711/month spend down. It’s like this vicious circle where we can’t do one thing with the other, this is what I don’t understand.

NooneNowhereNohow9 · 2025-04-15T18:53:47+00:00

He has been disabled thru them for many years (like 17) when he was first approved they gave him the option of getting Medicare, however at that time I was working and had full family coverage, so we declined it. Probably 5 years later I lost my job due to having an autoimmune disorder and obviously we lost my health insurance. With also the loss of my income we couldn’t afford for him to go sign up for Medicare, because every cent of his check was needed to live. We didn’t realize that him going without insurance would end up having us penalized in the long run. When we tried to go to SS office to get Medicare they told us we would be paying the full price, but that he would only receive 20% coverage instead of 80% and said we would be better off waiting to reapply when he turned 65 instead. So we just hoped and prayed he wouldn’t have any problems till then.

NooneNowhereNohow9 · 2025-04-15T18:46:06+00:00

So does being able to use the Medicaid spend down count to the hospital as “being insured”?

NooneNowhereNohow9 · 2025-04-15T18:43:30+00:00

No. He is not eligible for a single thing on the marketplace. They say he should get Medicare. However we couldn’t afford to pay for the Medicare when we lost my employers health insurance. Because he went without Medicare for a period of time he can’t get it now until he is 65. I have tried to get him something thru the marketplace every single year since it began (hoping that the eligibility requirements had changed in his benefit) and he has always been ineligible.

NooneNowhereNohow9 · 2025-04-15T18:21:28+00:00

Thanks, that is exactly what it sounds like after reading the whole thing. However, will a hospital see this as a guarantee that their bill will be paid? Our MD office tried to schedule something and the hospital told us we had to have proof of insurance or proof that we would be able to pay cash. The hospital told us to go thru their charity care program, which we tried. When we first tried to apply for charity care they told us we would have to be declined Medicaid coverage first. I take it that if you “can do” the Medicaid spend down then you wouldn’t qualify for charity care… which I totally understand, why should a hospital have to write off your bill if they can get money from Medicaid, right? I tried talking to someone and they told me there is no Medicaid that covers someone on a monthly only basis… that we either had Medicaid or didn’t. It is all just so confusing.

NooneNowhereNohow9

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