GOLDEN VALLEY, Minn. — Your annual physical is supposed to be free, right?
So why do you always feel like you’re being accused when you ask questions about your health? Isn’t that what a medical exam is for? Jonathon Hess of Athos Health has some answers for us.
We must first examine why this medical examination is free. This is because it is covered by the Affordable Care Act (ACA), sometimes called “Obamacare”. When this took effect in 2011, the federal government ensured that everyone had access to free preventive (or “preventative”) care. The goal is to ensure that illnesses and problems can be detected quickly by your doctor.
Everything related to preventative care is fully covered by insurance, so you don’t have to pay anything out of pocket.
This is where it gets tricky.
If you are in good health during your annual physical, you will pay nothing. But if you go to your doctor and say something like, “My knee hurts,” all of a sudden you could be billed for an office visit.
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This is because when you ask your doctor about something wrong with you, they will start trying to diagnose you and help you manage your condition. This transforms your visit from a preventative medical visit to a diagnostic visit, Hess says. This is no longer preventative care and is therefore not covered by the ACA.
Unfortunately, there isn’t exactly a solution to this problem. If you have a problem that you need to talk to your doctor about, you will likely either have to pay a co-payment or pay for the full office visit if you are on a high-deductible plan and have not met your deductible .
You can either ask these questions during your physical or schedule a separate visit. But the cost will probably be the same.
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Another important thing to remember: If your doctor and the lab that performs your tests are not in network, the services will not be considered preventive care. Your insurance company will not cover these out-of-network visits.
You can go to HealthCare.gov to find out what services are included in preventive care for all adults, womenAnd children.
If you have a question about your healthcare costs or a topic you would like us to cover in Health Care Tipssend us an email to Healthcarehacks@kare11.com.
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