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Costs Associated With a Cardiologist in NYC

Costs Associated With a Cardiologist in NYC

Patients have a lot of questions about the cost of medical care, especially with all of the problems reported with registering for Obamacare and Medicare Advantage plans.  Cardiologist-NYU

The selection window for Medicare recipients is now closed for 2014. Barring a late registration fee or the rare exception, you’re locked in to your insurance coverage for the next 12 months.

While the same can’t be said for the rest of the country just yet, if things go as planned, the American public will be looking at a similar lock-down.

What does this mean for your cost of long-term care? More practically, how expensive is a visit to your cardiologist in NYC? We will attempt to answer these questions in the remainder of this article.

Paying the Tab: The Adjusted Cost of Medical Care

There are a couple of important distinctions to be aware of in your insurance coverage for 2014:

1. Your insurance company will still cover a large portion of specialist-based healthcare costs. This includes something like your cardiologist in NYC.

2. The premium you pay for that coverage will depend on how long you’ve had the condition and your compliance with prescribed treatments.

3. Pay particular attention to your deductibles, co-pays, and other insurance fees; they will be higher this year.

4. If your cardiologist in NYC is closed to your insurance carrier, that means you will have to cover the cost of seeing that specialist out-of-pocket. While there are financing options available through the clinic, use in-network providers whenever possible. The decision here should depend on your relationship with your specialist.

All in all, you may be paying a larger portion in fees than you are used to, but you will not be expected to cover the full amount of your care if you have active insurance coverage and stay in-network.

Sticking to the Affordable Game Plan

There are strategies you can use to make these plans more affordable:

1. Lower your premium by showing evidence that you are compliant with treatment. This is the equivalent of “time off for good behavior” where an insurance provider is concerned.

2. Look into supplemental coverage to make up the difference for what your regular insurance provider doesn’t cover. Depending on the circumstances, this may be a more cost-effective approach.

Your cardiologist in NYC can help you navigate the new coverage restrictions.

The question of whether or not cardiology consultants are affordable has become more difficult to answer in recent months. For that reason, we will be focusing on the question of affordability for the remainder of this article.

The difficulties surrounding the Obamacare website aren’t the only roadblocks raised by the Affordable Healthcare Act. We will examine the less obvious difficulties and let you know what you can do to minimize them and find a cardiologist in NYC who meets your needs.

The Amazing Disappearing, Reappearing Act of Medical Affordability

We are in the very early days of “affordable healthcare” in the United States. As such, the future of healthcare coverage remains to be seen. That said, some changes are already taking effect.

It’s no secret that a zero premium plan comes with higher co-pays. That’s the trade-off for not paying a monthly premium. However, the co-pays have been on the rise over the last several months. To give you an idea of what this looks like, let’s run a comparison:

  • Last year the co-pay for seeing your primary care physician averaged $10.00. Now, it averages $15.
  • Last year your co-pay for seeing a specialist averaged $30.00. Now, it averages $50.00.
  • A hospital stay in 2013 cost you $250.00 per day for the first four days before Medicare coverage kicked in. Now, it will cost you around $430.00 for the same four days.
  • Urgent care and prescription drug coverage remains relatively consistent, but check the deductibles and you will likely see an increase.

Getting a plan with a monthly premium may seem wise, but the premiums have gone up too.

What “Premium Care” Really Buys You?

Premiums that were as low as $40 to $50 have increased to about $75 a month. That adds up to just under $900 a year.

While this does lower your co-pays, consider how often you go to the cardiologist in NYC before selecting a premium plan. It may be wiser to pay higher per appointment costs than to pay a monthly premium.

What does this mean for the continued affordability of your cardiologist in NYC? Well, you have three options:

1. If you are bound by in-network physicians, stay in-network when selecting a consultant.

2. Pay the penalty and change to a network-free PPO.

3. Ignore the in-network rule and either request that an exception be made or pay for your appointments out-of-pocket. You can always make financial arrangements in-clinic.

Consider limiting your care to what is absolutely necessary, thereby keeping affordability front-of-mind.

The Limits of Medical Testing

Chest pain is a symptom that causes panic for patients and caution for cardiologists. In reality, it’s a 44/56 split when it comes to the symptom being related to a serious heart condition. About 44% of patients are tested unnecessarily, while 56% show signs of needing urgent cardiac care.

How do you know what side of the split you’re on? That depends on finding the right doctor for chest pain.

All chest-related symptoms should be evaluated by a medical professional. However, how that symptom is handled varies greatly on a person-to-person basis.

There is a big difference between emergent cardiac care and managed cardiac care. You should always see a doctor for chest pain, but unless you are having acute symptoms, it is a good idea to discuss all of the treatment options available before you proceed with numerous diagnostics.

Patients who find a doctor for chest pain that participates in shared decision-making can cut the cost of care by 50%. This is particularly good news, because so many of the less invasive tests come back inconclusive or only serve to prove that the patient is at low-risk for a serious form of heart disease.

More and more experts in the cardiology field are recommending the shared decision-making approach so that a patient’s risk of complications and misdiagnosis are greatly reduced. In addition, they are able to assess all of the diagnostic information and actively participate in their own treatment plan.

Go on the Offense, not the Defense

The rule of thumb in cardiology used to be executive testing, meaning that no matter your risk level for heart disease, you would get cardiac function testing and screenings every year.

As you can imagine, this approach proved not only costly, but unnecessary. Since this approach has been reevaluated, experts are now recommending patients undergo less cardiac testing, not more. Patients who take part in their own treatment decisions fair just as well as or better than patients undergoing a full battery of tests for chest pain.

When looking for a doctor for chest pain, try to find one that takes the most balanced approach possible, giving you a chance to offer input, but stepping in when critically necessary.

Dr. Seldon, a Heart Doctor and Cardiologist in New York City, offers same day appointments and all testing is done on site.  Call us at (212) 367-8000.



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