To ensure the use of preventive care like shots and services, the Affordable Care Act of 2010 requires health plans to pay for these services without charging their members. Free is the incentive for us to do the right thing like colonoscopies without copayments or using our deductibles. The preventitive care benefits cover 22 adult services, 27 additional women services and 29 services for children.
Christine Rogers, 60, of Wake Forest, North Carolina is insured by Cigna Healthcare through her job. Christine had an annual wellness visit that included typical blood tests as well as a depression screening and discussion with a physician. Cigna was billed $487, which included a $331 wellness visit and a separate $156 charge for what was billed as a 20- to 29-minute consultation with her physician. Her insurer paid $419.93, leaving Rogers with a $67.07 charge related to the consultation.
What is the catch?
Not all care provided during a wellness visit counts as no-cost preventive care under federal guidelines. If a health issue arises during a checkup that prompts discussion or treatment — say, an unusual mole or heart palpitations — that consult can be billed separately, and the patient may owe a copayment or deductible charge for that part of the visit.
Who is supposed to understand all the nuances of Federal Regulations? Our healthcare system is too complex. Gallup found that 38% of patients defer care because of cost. I wonder how many people defer free preventative care because that don’t believe it to be true.
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