Login
Home
Health Insurance
Wellness
Travel Insurance
Life Insurance
Retirement Solutions
About MBF
Contact Us
Demutualisation
Get a quick quote
Health insurance options
Switch to MBF
Member benefits
in2life
Using your insurance
Common questions

Heart disease: angina

This fact sheet is to help MBF members and their families be better prepared for the healthcare experience after a diagnosis of angina.

Not all of the information here will be applicable to everyone, so it is important to discuss your individual circumstances with your doctor and perhaps with other healthcare professionals in the team caring for you. Please, never hesitate to ask 'why' or to have something explained to you until you understand it. If, after you have been given an answer, you still feel as though there are unanswered questions, ask again or ask someone else. You can help the healthcare team to help you if you feel free to communicate your needs to them. Further research and reading (see 'Learn more about angina and its treatment') will also help you make more informed decisions about your treatment.

What is angina?  

The heart is a muscle and although it is the pump that sends blood throughout the body, it too receives nutrients and oxygen delivered by blood via the coronary arteries (those which surround and feed the heart itself). Angina is chest discomfort and /or pain that occurs when the heart does not receive enough blood through these coronary arteries, often because fatty deposits within these small arteries called plaque are blocking the normal passage of blood or due to blood clots in the arteries.

The lack of necessary nutrients and oxygen delivered by the blood in the coronary arteries results in potential damage to the muscle. You often feel this as pain and/or tightness (often like a heartburn or squeezing sensation), usually around the centre of the chest, and that may be accompanied with a shortness of breath and sweating. Symptoms may also include pain or discomfort in the left arm or hand, neck, jaw, upper back or shoulders.

Angina is not a heart attack - permanent damage has not yet occurred - but it is an early symptom of heart disease. It is a sign that a heart attack may occur if the underlying cause is not treated. In some people, blood flow to the coronary arteries can also be reduced without causing angina. This is harder to pick up.

Top

Your treatment options  

Treatment is usually a combination of medication, lifestyle changes and, in some cases, one or more surgery or procedure options. The exact treatment will depend on several factors, including the cause of the angina, how far the underlying condition has progressed, and your general health.

Several different types of medications may be prescribed to address different conditions that can all contribute to coronary artery disease. For example medications may be prescribed to:

  • lower blood pressure;
  • lower cholesterol levels;
  • reduce the heart rate;
  • prevent blood clotting; and/or
  • to help with the pain itself.

Always share a list of the drugs you are currently taking with your health care provider, including your chemist, when discussing your medication options. Write a complete list of all the current drugs you are taking, including the name of the drug and the dosage (typically stated in mg). Remember to include those drugs prescribed by other doctors and drugs and supplements you buy over-the-counter without a doctor's prescription, even if you take them occasionally.

It is extremely important to continue taking medications as prescribed by your health care providers even if you are feeling well. It is also very important to be well-informed about the medications you have been prescribed, including interactions with other medications you may be taking and with alcohol.

Lifestyle changes are likely to be recommended by your doctor to improve your overall health status and to improve your heart's ability to receive blood through the coronary arteries. These may include:

  • stopping smoking (the first and most urgent advice for smokers);
  • losing excess weight;
  • regular gentle to moderate exercise;
  • reducing salt intake (if high blood pressure is a problem);
  • reducing alcohol intake; and
  • resting appropriately to avoid excess tiredness.

Surgery may also be recommended in certain cases. The most likely options are angioplasty, a procedure to help widen blocked arteries, including in many cases insertion of a device called a "stent" which acts like scaffolding inside the artery and helps hold the artery open; and/or coronary bypass surgery in which diseased or blocked arteries are replaced with healthy blood vessels from a different part of your body. Depending on the state of your arteries, you may be advised that open heart surgery to replace the damaged or blocked parts of the arteries would be better for you, even if it is a bigger procedure. These possibilities need to be discussed with your specialist.

It is generally agreed that whatever other treatment you require, the best chance for long-term health includes making lifestyle changes. Medication and surgery may be necessary, but without improving lifestyle habits (such as healthy eating habits and stopping smoking), they are unlikely to be as effective over time.

Like other muscles in the body, you can train your heart to be stronger with an appropriate exercise regime. However, excessive exertion, excessive eating and strong emotion trigger many angina "attacks". Try to identify your triggers and avoid them whenever possible to decrease the number of angina attacks.

Top

Angioplasty, stents and coronary bypass surgery  

Angina is a sign that blood is not flowing to your heart muscle as easily as it should. Whether or not your doctor has recommended you to be on medications, your specialist may recommend a procedure to change the condition of the arteries, such as angioplasty that may or may not include inserting stents into one or more of your coronary arteries. A stent is a wire mesh tube that is put in place inside the artery to hold the artery open to allow "better" or increased blood flow. Read 'Questions to ask your doctors' to prepare for discussions with your specialist so that you feel you have made an informed decision regarding stents.

From a health cover perspective, a stent is a prosthesis. A prosthesis is a device that is surgically implanted during a stay in hospital. Read 'What MBF pays toward treatment' to better understand whether or not the charge for stents is paid by MBF under your cover.

Questions to ask your doctors 

Generally, a GP will initially refer you to a specialist cardiologist for evaluation and to oversee your care. Your GP may then also be closely involved with your ongoing treatment. If you need bypass surgery, a specialist cardiac surgeon will usually perform the procedure. Usually, your GP will suggest one or more specialists and give you a referral.

To your GP/Referring Doctor:

  • What specialist/s do you recommend?
  • Why do you recommend this particular specialist?
  • Do you know the type of procedures I am likely to need?
  • How experienced and expert is this specialist in this area?
  • Do you know anything about the other specialists that may be involved?
  • Do you know if they charge a gap that Medicare or my health fund won't cover? Even so, choose your doctor first on their experience and expertise.

To the Specialist:

  • Will you please explain, in simple terms, the treatment you are recommending?
  • Why do you think this is the best treatment option for me? What are the other options, and are there particular advantages or disadvantages, or greater or lesser risks, with any of those other options?
  • Is surgery of any kind, including to implant a device such as a stent, the best first line treatment option for me?
  • Are there any lifestyle changes and / or medications that I can try first before having a procedure or surgery?
  • If you have prescribed a drug, are there any important side-effects I should know about?
  • What are the likely outcomes of my treatment?
    • What are the chances that the outcomes will be good with this treatment or with the alternative options?
    • How is it likely to affect any pain, shortness of breath or tiredness that I have been suffering and how will it affect the possibility of having further heart problems in the future?
  • What are the possible complications and/or side effects of my treatment, especially my medication or the procedure proposed? How can I reduce the risks?
  • What sort of monitoring or follow-up treatment do you expect me to need?

Top

If your doctor recommends surgery or another cardiac procedure:
(also see ' What MBF pays toward treatment')

  • Can you explain the type of procedure I am likely to need? How many of these have you performed? How many do you do each year?
  • Why do you think this is the best treatment option for me? What other options are there?
  • How long do you expect me to be in hospital?
  • If I require a stent(s)
    • Can you just confirm the stent you intend to use is a 'no-gap' prosthesis? A very small number of the prosthesis implants can have an associated out-of-pocket charge, but there are almost always similar no gap items available.
    • (And then …) If my stent requires a gap, what is the 'gap' and is there a comparable stent that is a no-gap prosthesis? If not, can you explain why you feel it is necessary to use this particular device?
  • What are the possible complications and/or side effects associated with my surgery?
  • What can I do prior to hospital, to reduce my risk for complications?
  • Discuss healthy weight, appropriate exercise, how to quit smoking and/or your current medications with your doctor. If you are diabetic, well-managed diabetes prior to your surgery will also help your recovery.
  • Should I stop taking any of my medications prior to going to hospital? If so, how long before?
  • What is my expected recovery time?
  • What restrictions will I have regarding my everyday activities when I go home (such as exercise and other activities, driving or lifting heavy objects)? If so, how long am I likely to need assistance?
  • Do you charge a gap that Medicare or my health fund won't cover? Even so, always choose your doctor/s first based on their experience and expertise.
  • Does the anaesthetist or any other doctor who may assist with the procedure charge a gap? If so, how much should I expect that to be?

What MBF pays toward treatment  

Understanding how the healthcare system works can be confusing. This brief summary outlines what you can expect in terms of your health cover, hospital and medical costs. Always check with MBF before you go to hospital.

Your hospital costs  

MBF Advantage Hospital, MBF Premium Hospital and MBF Standard Hospital cover will help pay for surgery and/or prostheses associated with the treatment of angina provided that:

  • you have the procedure while you have been formally admitted in a hospital;
  • it is a treatment for which Medicare pays a benefit;
  • it is not an Excluded Service on your level of cover; and
  • you've met all the standard conditions of your membership (like serving the relevant waiting periods).

MBF hospital cover will pay for the following treatments and services so long as you are formally admitted to the hospital and the above conditions are met:

  • shared accommodation (or private room if available);
  • surgery- related expenses including operating theatre and intensive care if needed;
  • certain therapies such as cardiac rehabilitation, physiotherapy and occupational therapy when provided by the hospital and associated with your hospital treatment;
  • certain drugs supplied as part of your inpatient hospital treatment; and
  • the full cost of a government-approved surgically-implanted prosthesis selected from the 'no-gap' list developed by the Department of Health and Ageing. Visit here for more about prostheses and your health cover.

Please note that cardiac procedures, including those associated with angina, are Excluded services under MBF Budget Hospital cover. This means no benefit will be paid by MBF under this level of cover for hospital and doctors' charges associated with that admission, including angioplasty surgery and stents.

Please note that Medicare pays a Medicare benefit toward out-patient cardiac rehabilitation.

Remember, if you are not in an MBF Network Hospital and/or public hospital, you may incur substantial out-of-pocket expenses for your hospital charges.

Please note that the surgeon's and other doctors' charges will be part of your medical costs.

Top

Your prosthesis costs  

Stents, which may be inserted during angioplasty, are prostheses. Should your specialist or surgeon feel one is necessary, you should have one or more prostheses available to you with no gap. The cost of a no-gap prosthesis will be fully covered by your MBF hospital cover so long as you hold an appropriate level of hospital cover and standard conditions are met. These conditions include waiting periods, any known Excess or Co-payment and any applicable Exclusions on your level of cover.

In a small number of cases, there may be other more expensive stents that your surgeon or doctor may recommend that could attract a gap. Where your surgeon recommends a stent that attracts a gap and you agree to that stent, you will have to pay a gap amount. Ask your surgeon to explain why he or she is recommending this particular stent over one without a gap.

If applicable, when and where to pay your prosthesis gap

When you are admitted to hospital for surgery, the surgeon should have made the hospital aware that a gap-prosthesis will be used for your procedure. The hospital will often ask you to the pay the prosthesis/device gap payment when you are admitted to hospital.

Your medical (doctors') costs  

If you will be going to hospital and/or having surgery, ask your doctor/surgeon to explain the costs of your admission and/or surgery, including any prosthesis/device gap amount, their own fees, any fees that other doctors involved in the surgery might charge and any other expenses involved. If there are any gaps for you to pay, ask for a written cost estimate. This is known as informed financial consent. Obtaining this information is extremely important before any planned hospital admission.

Remember, there may be more than one doctor involved in the procedure. These may include the cardiac surgeon, an anaesthetist and an assistant surgeon. You may not meet them all in person.

Each doctor will charge for his or her services. See Going to hospital and Gap and informed financial consent for a guide to these costs.

Key things for you to know about medical costs and your health cover are:

  • MBF will pay benefits toward your doctors' charges for the service you receive:
    • when formally admitted as an in-patient in hospital or day surgery, and
    • when the service relates to treatment included under your level of cover, and
    • when you are entitled to a Medicare benefit for the treatment.
  • The Medicare Benefits Schedule Fee ('MBS') is the amount determined by the Commonwealth Government for the purpose of paying Medicare Benefits. For eligible in-patient services, Medicare pays for 75% of the MBS; MBF pays the remaining 25%.
  • Many doctors charge above the MBS, creating a 'gap' - an amount the patient has to pay.
  • MBF does not pay any amount charged by your doctor above the MBS unless there is an agreement in place between your doctor and MBF. This agreement is known as the MBF Medical Gap Cover Scheme.
  • MBF has created the MBF Medical Gap Cover Scheme to help reduce gaps paid by members. Doctors who participate in this scheme have agreed to accept the MBF benefit as full payment for your treatment. If a doctor has agreed to treat you under the MBF Medical Gap Cover Scheme there will be no 'gap' to pay for that doctor's charge.
  • It may be that not all doctors involved in your hospital treatment are 'no gap' doctors. So you may have to pay a gap for some doctors' services, but not others.

Remember, doctors are independent of MBF and can decide whether or not to treat you under the MBF Medical Gap Cover Scheme.

Click here for a list of 'no-gap' doctors or call MBF on 131 137.

Top

Other costs relating to your treatment and recovery  

Depending on your level of MBF extras cover, MBF can also help with the cost of:

  • dietetics provided by a Registered Dietitian to help establish good eating habits;
  • complementary therapies such as therapeutic massage;
  • pharmacy including most prescribed non-PBS listed medications, and
  • gym membership fees and other activities such as yoga through MBF Living Well Programs cover (restrictions apply).

MBF extras benefits are only payable for services provided in Australia by an MBF Recognised Provider. MBF Recognised Providers are health service providers that meet MBF guidelines. Call 131 137 to confirm whether or not your provider is a MBF Recognised Provider.

You can enjoy higher benefits on all preventive and general dental services and selected physiotherapy, optical, pharmacy and gym membership services (restrictions on claiming apply) by using the growing MBF MemberCare network of service providers. With our MBF MemberCare network of providers, you are guaranteed of receiving at least 70%-90% of the charge back on selected services depending on your level of cover, up to the annual limit of your cover. Find an MBF MemberCare service provider.

Top

Learn more about angina and its treatment  

HealthInsite, The Commonwealth Government's Department of Health and Ageing consumer information website offers a range of information on heart health and treating heart disease.

More about going to hospital, MBF Network hospitals, no-gap doctors, and MBF MemberCare providers  

As well as calling MBF, you can find plenty of useful information about your health cover and what to expect when you go to hospital right here on this website.

Top

Last updated: 05-06-07

Print this page