Insurance question

I had my closure via catheter approach in December 2014. The surgeon at the time said not to worry about insurance that it would be covered. Well, I am now filing an appeal to the insurance company as they say PFO/ASD closures are experimental and therefore I owe $44,000 to the hospital. I wrote an appeal letter , as did the surgeon. Has any one else had an issue like this?

No my insurance paid and I knew before the closure. Did you have a PFO or an ASD patched? I have read about PFOs being experimental. I am going out of state to have an ablation for VT and I am going to know if it is covered before it is done. If it is not covered I will have it done local, even if this doctor is said to be better The insurance problem is no better in the USA. I had hoped it would be better but no such luck. Good luck with your appeal.

Dave, how has this drama played out? My name is Seenie, and I'm part of Ben's Friends moderator support team. I come here looking for things that I can help with, and I happened to notice this discussion. Yikes. Don't leave us in suspense -- I hope you've managed to get this sorted out.

I'm sure I'm not the only one who is wondering!


It was an ASD and a PFO next to it so I’m hoping that helps my case with the ASD. I received a letter today from the Illinois Insurance Board saying I definitely “qualified” for an external appeal. So they have forwarded it to the external appeal department and the waiting game begins again! I will let everyone knows how it goes. I’m definitely glad I had the surgery as there are many things it helped with. But I also battle Psoriatic Arthritis and Pulmonary Arterial Hypertension so life gets a little crazy and it would be nice to get a break from paying that extremely large bill:)
Hopefully I will hear soon and give an update!