Respected EP in Louisiana for AFIB Ablation?

I am doing great after my 2nd Ablation with Dr. Natale in June 2016. My problem now is not Medicare but the type of supplement I use to have a surgery paid for out of state. A Medicare Advantage Plan is much cheaper than Medigap coverage. I have always used the more traditional plan meaning Medicare Part A and B with a Part N supplement. This does give one the freedom to choose his Doctor whether it’s in state or out of state. Medicare Advantage programs combine benefits together but it is a PPO or HMO USED within the state you reside. This type of plan is half the cost but out of state use is only for emergencies meaning Texas would be out of network.

Does anyone know of a Ablationist in Louisiana that is known to be reputable not just another EP?
I am hoping I never have to have another Ablation but there is never a total guarantee.

Why not just switch to a plan that covers out of state doctors should you ever need another one? Switch, get the ablation done, then switch back to the cheaper plan later. I doubt you'll ever need another one after two years of freedom, but if you do I think it's worth a few bucks to go back to Natale. I wouldn't let any other EP in the world touch me at this point (5 failed ablations from other EPs and one successful one from Natale).

Switching is not that simple. You have a certain time period to make changes and also you most likely will be subject to a physical which could cause issues. This is why I would like to have a EP with known experience like Dr. Natale.

Okay, I probably shouldn't comment on medicare questions since I'm not very knowledgeable.

I'm sure there are very competent clinical electrophysiologists in Louisiana, but I don't think there's anyone on par with Natale.

I'm seeing my local EP tomorrow for a routine followup because he's an outstanding EP who I want to maintain a relationship with. I know he's a very competent ablationist, one of the top in the northeast, and if I'd gone to him first I think I'd be in a very different situation with 3-4 fewer ablations, but nevertheless I would never consider him again for another ablation. I think having a local clinical EP is worthwhile, but choosing an ablationist is a very different matter and that's not a place to save money.

Anyone know of a EP with excellent credentials in Louisiana? My local Heart Doctor is not a EP. He is a good man but really old school when it comes to AFIB. For instance, when I was diagnosed with persistent AFIB, He immediately put me on Amiodarone 200 mg 2x a day and Cardizam plus Pradaxa. I was finally cardioverted 3 months later. I had to have a stent first. I stayed on Amiodarone for 9 months but I had some really bad side effects.
Anyway, I need a EP for my yearly visits.

Been a resident in the Big Easy all my life (I'll be 64 yrs old next month). I had my first two ablations (Feb 2015 and Feb 2017) done here by a very well known and respected EP and in a similar facility. Both ablations failed and the first procedure left me with a DVT in my left leg. Both local ablations left me significantly bruised and battered. I've had two ablations recently (Nov 2017 and April 2018) with Natale. Given my experiences, I agree with Carey. I would not let anyone other than Natale (and St David's) perform an ablation on my heart. I now see a local EP (at the same local facility) for check ups and such. He happened to be a fellow assisting on my very first ablation here so he knows my history. He's young, inexperienced, but obviously knowledgeable, and more importantly "honest". He's reviewed Natale's EP lab reports. He told me (1) I was their worst nightmare as a patient; and (2) there is no one at this facility (there are 7 EPs on staff several with 20-30 years of experience as practicing EPs) that could have done what Natale had done. Health care costs presents problems to us all! I guess the question comes down to what's the cost of one's piece of mind! Hope this help. Joe

I will pay for Part N Supplement with regular Medicare and continue with part D drug coverage Silverscripts. Not going to roll the dice. Staying put so I can choose who I want, where I want as long as they take Medicare without excess charges. Only 3-4% actually charge a Medicare excess charge.

Smackman,

Have been out of looking at Medicare plans since my mom passed in 2013. She was in a plan in her hometown that predated the Plans A, B & ect. She'd subsequently been diagnosed with cancer, so was unable to pass underwriting to get a new plan. Hers was very expensive. I switched her to a Medicare Advantage plan, knowing I would move her to be near me (out of state for her) as her cognition was declining. I did switch her to the Advantage. Of course, once you are in an Advantage plan you can't switch back to regular Medicare, unless you move out of their coverage area. When she moved, I switched her to a regular Medicare Plan. I selected the plan which only paid 50% of the copays & had a comparatively large deductible. It was the cheapest. My philosophy with insurance is to insure the big stuff (like operations and days in the hospital) and pay for the small stuff myself. When I analyzed it at the time, there was almost a $1 increase for every $1 you are insuring. So unless you are using it all the time, this seemed most economic to me. She did have a broken hip, but otherwise no hospitalizations for the 6 years I did this, so my economic assumptions worked out.

George

I have also been trying to figure out the best way to pay for a Dr Natale ablation while being on Medicare. The issue is complicated and I am no expert. You should go to one of the Medicare Enrollment period seminars to find out what is best for you. What I explain below may not apply in your case.

I started by looking up the insurances accepted on Dr Natale's TCA website at [tcaheart.com]. Near the bottom of the page there is a section with the title of "Medicare and Medicare Advantage Plans". Then you need to match up what Medicare Advantage PPO plans are available in your area. You need a PPO plan; HMO plans will not work. If you find a plan, you are all set. The only plans I have on the list in my area are Aetna and Medicare (Original).

The option with the most flexibility is Original Medicare. You can go to any doctor/hospital in the country that takes Medicare. However, you then need to pay 20% of the cost yourself. To get around this you need a Supplemental Plan to pay the copay and a drug plan (Part D). But the Original Medicare option will generally cost you more unless you have a lot of medical expenses. I have always used Medicare Advantage plans. You can switch from a Medicare Advantage plan to Original Medicare, but you may have issues with drug coverage depending the state you live in. Note that there are 2 enrollment periods when you can make this switch: the Fall Period (Oct 15 - Dec 7) and the Medicare Advantage Open Enrollment Period (Jan 1 - Mar 31). See the links below:

How to switch Medicare Advantage Plans or switch from Medicare Advantage to Original Medicare

Can I switch between Medicare Advantage and Original Medicare?

The simplest alternative, if you already have a Medicare Advantage plan, is to switch to a Medicare Advantage PPO plan, if you already don't have one. You can make this switch during the October Enrollment Period (now through 12/7/18) or during the Jan - Mar Enrollment period (new in 2019, but check). The other little known Medicare Advantage benefit that you may be eligible for is the Passport travel benefit (UnitedHealthcare only in most states including TX) or the Explorer travel benefit (Aetna only in AZ, CO, DE, FL, KY, MA, ME, NV, OH, PA and UT in 2017, but check for 2019). If you get this benefit then you will be charged for your ablation (or the parts of it) as if you were In Network in a hometown hospital with a hometown EP.

My research, for my case, shows that the UnitedHealthcare Advantage plan is best for me. I did check with Dr Natale's office and they said they will cover the ablation using the UnitedHealthcare Advantage plan. However, I will believe when it all works as planned. Your results may vary and you need to check with your own insurance company and Dr Natale's office. I would not be surprised if the financial part of paying for a Natale ablation is more complicated than the medical part.