Cost
Estimated Medicare patient out-of-pocket (OOP) costs for the WATCHMAN Implant
A typical Medicare patient in 2024 will pay no more than $2,607 in out-of-pocket costs to receive the WATCHMAN Implant.1
Total out-of-pocket spending for the WATCHMAN Left Atrial Appendage Closure Implant (LAAC) is lower than that of warfarin and non-vitamin K oral anticoagulants (NOACs) by year 5.
The WATCHMAN Implant provided Medicare patients with lower out-of-pocket costs at 5 years relative to both warfarin and NOACs.
Annual Cumulative Patient OOP Costs5
The WATCHMAN Implant had lower patient OOP costs than NOACs by year 3 and warfarin by year 4.5
Average Total OOP Costs at Year 55
The WATCHMAN Implant was 33% less expensive than NOACs and 26% less expensive than warfarin by year 5.5
Note: Estimated costs are based on national averages of 2024 U.S. Medicare rates, and assume a 20% copay for Medicare Part B. These estimates will vary depending upon the patient’s individual healthcare policy. Insurance coverage can vary significantly from one plan to another, even within the same insurance company. We therefore recommend that patients contact their insurance provider directly with questions regarding estimated patient-specific out-of-pocket costs.
- The pre-screen TEE cost will be different if it is completed within 72 hours before hospital admission due to the 3-Day Payment window. Source: CMS MLN Matters, SE20024, December 3, 2020.
- Patient Costs are calculated based on Medicare beneficiaries 20% coinsurance payment for Part B services, for both hospital (where applicable) and physician work. Rates are CY2024 Medicare rates set by the CY2024 CMS Physician Fee Schedule and CY2024 CMS Hospital Outpatient Prospective Payment System Annual Rules. Payments from Optum, Inc. Accessed 02/23/2024.
- Traditional Medicare beneficiaries 2024 Deductible for Part A ($1,632) and B ($240) may have already been met for patients if they have had prior medical services unrelated to WATCHMAN procedures.
- GoodRx.com, Costco pricing for Warfarin, Clopidogrel and ASA
- Reddy VY, Zhong Y, McGovern AM, Amorosi SL, Gavaghan MB, Hertz DS, Low K, Freeman S, Holmes DR Jr. Comparative Costs to Medicare and Medicare Beneficiaries of Alternative AF Stroke Risk Reduction Strategies. Clinicoecon Outcomes Res. 2024;16:81-96.
Health economic and reimbursement information provided by Boston Scientific Corporation is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules, and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice. Boston Scientific encourages providers to submit accurate and appropriate claims for services.
It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services, and to submit appropriate codes, charges, and modifiers for services rendered. It is also always the provider’s responsibility to understand and comply with Medicare national coverage determinations (NCD), Medicare local coverage determinations (LCD), and any other coverage requirements established by relevant payers which can be updated frequently. Boston Scientific recommends that you consult with your payers, reimbursement specialists, and/or legal counsel regarding coding, coverage, and reimbursement matters.
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