Mula2 saya cuba tulis dalam BM tetapi disebabkan terlalu banyak terminology perubatan. Ia lebih sesuai di tulis dalam BI. Let me know in the comments if you prefer me to write in BM or BI in future articles.
I also hope this article doesn’t land me in trouble. Disclaimer: This article solely represents my personal opinion and does not reflect the views of my employer.
In the complex world of healthcare, accuracy is not just important, it’s vital. But what happens when a misclassification triggers a wave of misunderstanding? During my deep dive into health insurance policies (I sometimes do this to get familiarize with policies to assist my patients with their claims), I discovered an inaccuracy inside a critical illness policy from a leading Malaysian insurance company.
I provide the link here (which remains uncorrected as of 11 April 2024) that will lead you to “Big 3 Critical Illness Protection Plan.”
Then click on: 24 conditions (at the bottom of the screenshot) which would bring you to another page.
Understanding EECP Therapy
EECP, or Enhanced External Counterpulsation, is an FDA-approved therapy for long-term stable chest pain, may sound complex, but its core concept is simple. It’s a non-invasive treatment typically administered in outpatient clinics, and sometimes even in shop lots. During EECP treatment, cuffs are applied to your legs to apply pressure to blood vessels, thereby enhancing blood circulation to your heart. Patients usually undergo this therapy for a total of 35 hours: one hour per day, five days a week, for seven weeks.
This therapy is recommended for a specific group of patients suffering from long-term (chronic) chest pain that could limit their activities. It’s often considered when other interventions, like angioplasty or coronary artery bypass graft, have been performed or aren’t feasible; or when symptoms persist despite optimal medication and/or without other therapeutic options.
However, it’s crucial to note that there is no data indicating EECP prolongs survival. Therefore, if you don’t experience any chest pain, there’s no justification for undergoing EECP.
The scientific mechanism suggests it may stimulate the development of small blood vessels supplying the heart. The American College of Cardiology currently labels it as Class IIb, backed by moderate-quality evidence (Level of evidence B) supporting its usefulness.
(Class IIb: indicates that the usefulness or efficacy of a procedure or treatment is less well established by evidence).
Regrettably, there are centres in Malaysia that unethically offer EECP as a first-line therapy to clients who do not need it. And most of these clients have not undergone proper assessment and treatment by cardiologists. These centres often charge exorbitant price.
And how about IABP?
IABP, or Intra-Aortic Balloon Pump, is a medical device considered as an invasive procedure performed inside hospitals by cardiologists for unstable patients experiencing shock from a heart attack or in preparation for coronary artery bypass graft surgery.
The procedure involves inserting a slender tube called a catheter into the aorta, the main artery leaving the heart, with a balloon at its tip. This balloon inflates and deflates in coordination with the heart’s rhythm, aiming to provide mechanical support and improve blood flow to the heart, thereby reducing the heart’s workload. It’s a lifesaving intervention for patients in critical condition, such as those experiencing cardiac shock.
The Confusion
The dilemma arises as it’s uncertain which therapy the insurance company intends to cover, whether EECP or IABP. To navigate this confusion, it’s advisable to reach out to the insurance company directly or consult with your insurance agent for clarification. So far, I have not been able to reach the company for clarification. I called them before the fasting month, but their agents have not returned my call. This article is not intended to cast a negative light on this company. I am sure it is an honest oversight which might be explained further in their full policy. And I am sure they have their own medical panel that double-checks their policies. I hope they would come across this article and amend that part.
Your homework
If you come across the term EECP or IABP in your policy with your own company, please check if a similar error takes place. You could even check with your agent for clarification; they are there to help you. The dedicated ones will definitely help you to answer any uncertainty in your policy.
Conclusion: The Way Forward
In the intricate landscape of healthcare, effective communication and accuracy are pivotal. It’s imperative for insurance companies and their agents, healthcare providers, and patients to have a clear understanding of the treatments and procedures and which illness covered by their policies.
Terima kasih. I hope this helps. I welcome your feedback and any suggestion.
Heartpill 