Medical Devices: As Performance Improves, Coverage often drops
December 18th, 2008
By John Ghysels, Special to Technology-Report.com
First the good news; medical devices are getting smaller, more accurate, more convenient and downright cool. These devices will, quite literally, save your life. For instance, insulin pumps help control blood sugar levels, resulting in far less stress on the body and fewer medical complications over the long run. The advent of miniaturization, combined with the host of other small devices that we typically carry on our hips, means that these small machines are no longer the conspicuous, noisy bricks they once were. In fact, many folks often mistake them phones. The list of medical devices is also rapidly expanding, including portable defibrillators, pacemakers, c-pap breathing machines, infant monitors and even future devices that may control depression and other neurological disorders.
Unobtrusive; HiTechHealth
The bad news is that these life saving devices are expensive. The insulin pump above goes for about $6000, USD, with a 4 year warranty. This probably explains why many insurers and government programs are dramatically limiting coverage for these wonderous mini-machines. For instance, many private US insurers cover pumps like these subject to a $2000 limitation, if they cover them at all.
Further, insurance coverage contract provisions for these devices can vary dramatically from one insurance company to another and even between plans offered by the same insurer. A quick survey by Technology-Report showed shocking differences in coverage for insulin pumps, running the gamut from no-coverage, to 100% coverage, depending on the carrier and plan offered.
Unfortunately, coverage for most medical devices is often confusing and seldom clearly disclosed. For example, some insurance companies consider insulin pumps as ”Durable Medical Equipment”, subject to strict limitations, while others cover them generously as “diabetic management supplies”, with few restrictions.
The rapidly rising cost of healthcare is putting more pressure on insurers and cash-strapped government programs all across the world. Ironically, that may mean that as all these medical devices become more useful and accessible to more and more users, that coverage on them is likely to become even more limited.
Best to keep your eye on your healthplan coverage and do your research before making an investment in one of these wonderous new hi-tech health machines. Both individuals and governments are now having to make policy decisions on the value of both the quality of life, and even a life itself, when it comes to life improving, and life saving, hi-tech medical equipment.
New, Hi-Tech Healthcare: self managed care w/ technology
Hi-Tech Health, Medical Devices, Medicine, Science & Technology, medical technology
The labor intensive nature of health care would seem to suggest huge potential for cost cutting through technology though I suppose the trick is funding the really expensive research and development costs. Perhaps a good role here for Govt is to provide “x prize” style innovation prizes of millions for technologies that will save the Govt huge money but would not necessarily save anybody else enough to justify the prize cost.
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Yes. This, in the context of the earlier post on Overseas Care (Medical Tourism) points out the building demand for medical tech as the population ages. I note that Medical tech stocks have done well in the current downturn.
However, economic conditions is putting more pressure on governments and private insurers. These purchasers want a strong ROI. It is telling, however, that prominent data driven medical models, such as Kaiser Permanente, have eliminated Medical Device/Durable Medical Equipment coverage from some of their plans. Kaiser is a great plan, with excellent outcomes overall, so this suggests that the jury is still out on ROI for this hi-tech stuff, at least in general.
I’d say “The Rascal” is a great example of how government programs can be, potentially, abused. That vendor states that they will advocate aggressively to get you an expensive scooter from the US Medicare program.
Their claims are pretty questionable, according to the medical equipment vendors I’ve spoken to. The ad itself seems to cross a few boundries that are of concern.