INSURANCE COMPANY INVOLVEMENT ON POST-MYOCARDIAL INFARCTION CARE AND REHABILITATION IN THE UNITED STATES

The national extent of insurance company reimbursement of cardiac rehabilitation programs is unknown. Various projects, however, are being conducted and closely observed regarding their cost-effectiveness. For example, one Blue Cross and Blue Shield Plan has embarked on a cooperative state-wide evaluation of cardiac rehabilitation with responsible members of the medical profession and heart association. In this program the rehabilitation team is comprised of a cardiologist, exercise physiologist, nutritionist and psychologist.

In many areas the Blue plans will not include reimbursement for either ergometric testing or exercise programs, limiting their coverage to the acute in-hospital phase only. This is done in an effort to hold down costs of health care, operating on the philosophy that insurance is for disease only, and not for rehabilitation or prevention, laudable as these may be. When the Blue plans refuse coverage, major medical coverage may fill the gap.

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Cardio & Blood/Cholesterol

 

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