Does Medicare Cover the WATCHMAN Procedure?
Fair Square Medicare

Does Medicare Cover the WATCHMAN Procedure?

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By Daniel Petkevich

Dec 1, 2022

Find out if you qualify

Medicare beneficiaries who stay vigilant in preventing strokes might already know about the WATCHMAN procedure. What you need to know is that Medicare offers coverage for it. You do have to meet certain criteria, though. Keep reading to find out if you might qualify.

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What is the WATCHMAN procedure?

The WATCHMAN procedure is a non-surgical option for people with atrial fibrillation, or AFib. It’s an FDA-approved device that’s placed within the left atrial appendage (LAA) to close it off and keep blood clots from forming there. Once it's in place, the WATCHMAN device helps reduce the risk of stroke in people with AFib.

Who is eligible for Medicare coverage of the WATCHMAN procedure?

In order for Medicare to cover the WATCHMAN procedure, you must meet certain criteria. Medicare will cover the WATCHMAN procedure for those who meet the following:

  • Increased risk for stroke

  • Not being able to take long-term blood thinning medications

  • You must also have a referral from your doctor and be seen by a cardiologist or electrophysiologist (EP) who specializes in treating atrial fibrillation.

If you are approved, Medicare will cover all of the device-related costs associated with the WATCHMAN procedure. This includes the doctor’s office visit and hospital stay for the procedure, which will be covered Part A. Part B will cover any follow-up care related to the device placement.

You will be responsible for the Part A deductible, and up to 20% of the Medicare-approved amount for Part B. If you want to decrease your out-of-pocket costs, you should enroll in Medicare Supplement Plan G.

How to find a doctor who performs the WATCHMAN procedure

If you are interested in the WATCHMAN procedure, it’s important to find a doctor who specializes in treating atrial fibrillation. Medicare providers can help you locate an EP in your area that has experience with the WATCHMAN procedure.

When reviewing doctors and making appointments, make sure to bring up any questions or concerns you may have about the procedure. It’s also important to confirm that the doctor accepts Medicare before moving forward with any kind of treatment.

What are the risks and benefits of having the WATCHMAN procedure done?

The WATCHMAN procedure is generally safe and effective, however there are some potential risks associated with it. These include bleeding, stroke or device-related complications such as infection or damage to the implant site.

The benefits of having the procedure done include a reduced risk for stroke compared to those who do not receive treatment, as well as a decreased need for long-term blood thinning medications.

How to prepare for the WATCHMAN procedure

Prior to your WATCHMAN procedure, you’ll need to meet with your doctor and discuss any allergies or medical conditions that may be a risk factor in the procedure. You should also inform any other doctors who are treating you about the procedure so they can monitor your health accordingly. Additionally, it’s important to talk to your doctor about any medications you are currently taking and ask about how to prepare for the procedure, including when to stop taking certain medications. You may also need to fast before the WATCHMAN procedure, so make sure to follow your doctor’s instructions closely.

What happens after the WATCHMAN procedure is completed?

After the procedure, you will likely be monitored in a hospital for at least 24 hours. This is to make sure that you do not experience any complications from the procedure or device placement. You may need to stay on blood thinners for several months following your WATCHMAN procedure and then your physician can help determine if it’s safe to stop taking them. Additionally, you should follow-up with your doctor regularly to make sure that the device is functioning properly and that your body is healing correctly.

Takeaway

The WATCHMAN procedure can be an effective way for people with atrial fibrillation to reduce their risk of stroke. Knowing if you qualify for Medicare coverage will help make this decision easier, so it’s important to confirm that you meet the criteria and find a doctor who specializes in treating atrial fibrillation. Before undergoing the procedure, remember to talk to your doctor to ensure this is the right choice for you. This content is for informational purposes only. For all your Medicare questions, we are here for you at Fair Square Medicare. Call today to speak with an expert.

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