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Angry Patients Find Obamacare's Annual Checkups May Not Be Free
News Max ^ | 14 April 2014 | Drew MacKenzie

Posted on 04/14/2014 5:08:17 PM PDT by Lorianne

Obamacare patients who go to their doctors for a free annual checkup are finding out that they may have to pay for the preventive healthcare visit after all.

They are angry to learn that if they mention past or ongoing health concerns during the physical, that can result in co-pays and deductibles, according to The Wall Street Journal.

Under the Affordable Care Act, preventive care includes screenings for high blood pressure and high cholesterol counts, evaluations for several cancers and diabetes, and vaccinations. The patient is allowed, in most cases, one checkup per year.

But "wellness" care on potential new health issues is viewed as "evaluation and monitoring," and leads to patients having to fork out for the "free" annual physical.

"Patients are scheduling physicals because physicals are free," Randy Wexler, a family physician in Columbus, Ohio, told the Journal. "But they come in and say, 'I've been having headaches. My back has been bothering me, and I'm depressed.' That's not part of a physical. That will trigger a copay."

Wexler says they are not happy about the charges. "They'll say, 'I have diabetes and hypertension and heart disease and seeing you is preventing them from getting worse, so that should be fully covered,'" he said. "But under that theory, everything would be free with no copay."

Doctors told the Journal that seniors have started canceling their annual wellness visits under their Medicare plans when they learn that if they mention a current health issue during the checkup they will likely be charged a co-pay.

Some doctors are even warning patients in advance of the problem and ask them to schedule two visits, one for the "annual" and another for their current health issue, according to the Journal.

(Excerpt) Read more at newsmax.com ...


TOPICS: Culture/Society; Government; News/Current Events
KEYWORDS: copay; obamacare; outofpocket
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To: Lorianne

I actually just heard this at the presentation at my job today about the plan we are switching too. The broker (or whatever he was, he was not the guy from the insurance company) also said: you know how Obamacare has made prices go up.

I was a little surprised to hear a pro just say that straight out like that.

Not that it isn’t true of course!

Like I said this is a new place for me, but that made me feel pretty comfortable there.

The coverage and the cost is very much ok, so I am very grateful for that. And the big boss actually went himself and got extra chairs for me and 2 other ladies who were standing, so that was also very nice.


41 posted on 04/14/2014 6:46:25 PM PDT by jocon307
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To: LostInBayport

I can’t believe some of the things I had said to me throughout the Obamacare debate. Life long friends I’ve known for years were not only disagreeing with me, but accusing me of racism, hatred, greed, wanting people to die, etc.

There are a bunch of people I’ll never talk to again.

Well it turns out I’M RIGHT - so they can all SUCK ON THAT.

I hope every one of the gets COMPLETELY MANHANDLED under Obamacare.

You get what you pay for and this is “free”.


42 posted on 04/14/2014 6:49:28 PM PDT by Tzimisce
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To: peeps36

Don’t EVER trust ANYONE who says they want to control your life.

I don’t understand how so many can be so completely stupid.

But they’re about to learn....


43 posted on 04/14/2014 6:50:50 PM PDT by Tzimisce
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To: forgotten man

You are so correct about that.

In preparation for cataract surgery with my eye doctor had to go find a PCP for a physical. She ordered an EKG, visit to a Cardiologist, chest x-ray, extensive blood work and a stress test. Told her IMO that was overkill for cataract surgery.

Medicare denied all the blood work and so lab located in same office with PCP sent me a bill which was at 8 times the rate Medicare would have allowed. I paid them the Medicare allowance for three tests and told them they could write off all the rest, including the $20 charge they made for “Administration of Professional Guidelines on Chain of Custody Procedures Associated with Urine Specimens”. Also have received six other bills from places I never went for things I never agreed to. Just ridiculous.

Docs are so afraid of getting sued. Excessive testing should be justification for filing a lawsuit.


44 posted on 04/14/2014 7:01:35 PM PDT by Grams A (The Sun will rise in the East in the morning and God is still on his throne.)
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To: Grams A

Your post certainly rings true with me.

When I had surgery for cancer, I had to go in a week before and let them spend 2 hrs proving I was healthy enough to operate on, LOL.


45 posted on 04/14/2014 7:03:26 PM PDT by nascarnation (Toxic Baraq Syndrome: hopefully infecting a Dem candidate near you)
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To: RginTN
Doctors told the Journal that seniors have started canceling their annual wellness visits under their Medicare plans when they learn that if they mention a current health issue during the checkup they will likely be charged a co-pay.

How many seniors have no current health issues?

46 posted on 04/14/2014 7:28:06 PM PDT by Mygirlsmom (No Mo (zilla). I'm going to the Opera instead.)
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To: Jim Robinson
A whole bunch of really stupid people are about to find out there’s no such thing as free lunch.

Yes, these stupid people will. The question is: who will they blame?

47 posted on 04/14/2014 7:30:02 PM PDT by Mark17 (Chicago Blackhawks: Stanley Cup champions 2010, 2013. Vietnam Vet 70-71 Msgt US Air Force, retired)
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To: Lorianne
So what's new? I am on Medicare, have a few ailments, and when I go for my annual, they check out the status of my ills, run blood tests, etc. I have ALWAYS had a copay.

Good grief! What good is a physical if you go in, play dumb, and discuss nothing--a waste of time.

vaudine

48 posted on 04/14/2014 7:34:25 PM PDT by vaudine
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To: Lorianne

you need an I.D. card to have Obamacare, but you don’t need one to vote.........????


49 posted on 04/14/2014 7:44:42 PM PDT by terycarl (common sense prevails over all else)
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To: Lorianne

But he promised.


50 posted on 04/14/2014 7:58:32 PM PDT by TBP (Obama lies, Granny dies.)
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To: Lorianne

Extortion-Care is the Government LOBBY Work-Camp: Arbeitsziehungslager

krokr: “ACA” = traducer. Attempted body takover by the Dia-bolos Traducer. slavre: DRUDGERY, toil- Websters.

DRUDGERY is the Lobby-ist Workcamp.

“Resist the Diabolis, and he will flee from you.”


51 posted on 04/14/2014 8:43:39 PM PDT by Varsity Flight (Extortion-Care is the Government Work-Camp: Arbeitsziehungslager)
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To: Chode

No, it wasn’t a mistake. My husband was telling me about it, and I can’t remember what he said. It’s some sort of change.


52 posted on 04/14/2014 8:44:11 PM PDT by luckystarmom
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To: nascarnation

I had to go in a week before and let them spend 2 hrs proving I was healthy enough to operate on...”

I do hope that you are healthy and well now but your comment was just so funny.

When I went in for surgery on the second eye one nurse checked my chart notes from the first surgery and proceeded to have a fit because she said my potassium level was too high and they should never have done the first surgery until it was checked again.

I’ve not sure what she thought checking it again was going to prove. I did share with her that it should be obvious, even to her, I had survived the first eye surgery. Then she started quizzing me about when I had last eaten a banana and was not amused by my asking her, “Why, do I look like a monkey?”

It is all just so ridiculous. That’s why I don’t ever go to a doctor any more unless I simply cannot function and I absolutely refuse to take meds unless it is critical that I do so. God has given me a good and long life. I’ll leave it up to Him to decide when it’s over, not some nurse worrying about when did I last have a banana.


53 posted on 04/14/2014 8:46:46 PM PDT by Grams A (The Sun will rise in the East in the morning and God is still on his throne.)
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To: Lorianne
"Patients are scheduling physicals because physicals are free," Randy Wexler, a family physician in Columbus, Ohio, told the Journal. "But they come in and say, 'I've been having headaches. My back has been bothering me, and I'm depressed.' That's not part of a physical. That will trigger a copay."...uh - but an important part of any physical is a good medical history - sounds like the start of Death Panels to me - bureaucratic pencil-heads deciding what is and isn't included in effective medical care - every day is worse and worse.....
54 posted on 04/14/2014 9:05:18 PM PDT by Intolerant in NJ
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To: Jim Robinson

So true. It ain’t about healthcare.


55 posted on 04/14/2014 9:12:54 PM PDT by freekitty (Give me back my conservative vote; then find me a real conservative to vote for)
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To: luckystarmom
a screening colonoscopy and a polypectomy are two completely different CPT codes...

Screening Procedure Information for Colonoscopy and Endoscopy

If your colonoscopy has been scheduled as a screening colonoscopy (meaning you have no symptoms with your bowels), and your doctor finds a polyp or tissue that has to be removed during the procedure, this procedure is no longer considered a screening procedure, it is considered a surgical procedure and your insurance benefits may change. Please check with your insurance carrier prior to starting the bowel preparation. Symptoms such as change in bowel habits, diarrhea, constipation, bleeding and anemia constitute bowel symptoms.


Screening CPT codes 45378, G0105, G0121
Colonoscopy with biopsy 45380
Colonoscopy with polypectomy 45385 usual diagnosis code 211.3 or 211.4

If your upper endoscopy has been scheduled as a screening procedure (meaning you have no symptoms with your stomach), and your doctor finds any polyps or tissue that needs to be biopsied, the procedure is no longer considered a screening procedure, it is considered a surgical procedure and your insurance benefits may change. Please check with your insurance carrier prior to the procedure for detailed information.


Screening CPT codes 43235
Upper endoscopy with biopsy 43239
Upper endoscopy with polypectomy 43251

like i said count you blessings...

by the way, who is your insurance carrier?


56 posted on 04/14/2014 9:14:22 PM PDT by Chode (Stand UP and Be Counted, or line up and be numbered - *DTOM* -vvv- NO Pity for the LAZY - 86-44)
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To: Lorianne
"But they come in and say, 'I've been having headaches. My back has been bothering me, and I'm depressed.' That's not part of a physical. That will trigger a copay."

That makes sense to me. Why shouldn't it be this way? A physical is an examination and oral or written health history. Simply responding to the interview questions will not trigger the copay. Volunteering something separate most certainly can (if the office chooses to bill for it). But if you made a separate appointment to complain about the new condition you'd have to pay anyway. So what's the problem? Why should the physical include for free evaluation and/or treatment that is not part of the physical?

57 posted on 04/14/2014 9:26:00 PM PDT by steve86 (Acerbic by nature not nurture)
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To: Chode

Blue Shield of California PPO. I’ll ask my husband about why it was covered.


58 posted on 04/14/2014 9:28:57 PM PDT by luckystarmom
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To: Chode

Here’s a link that says polyp removal is covered:

https://www.blueshieldca.com/bsca/documents/about-blue-shield/health-reform/A45296_2-13.pdf


59 posted on 04/14/2014 9:32:20 PM PDT by luckystarmom
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To: luckystarmom
interesting reading... the screening with polyp removal has a "2"notation that leads to a clause at the bottom of the page stating that it varies according to age and gender

so it will be coded one way but billed another, i am glad you both are covered because a LOT of people go for a screening and wind up getting billed for a removal they were not expecting

thank you for taking the time to find the link, i appreciate it

60 posted on 04/14/2014 10:07:55 PM PDT by Chode (Stand UP and Be Counted, or line up and be numbered - *DTOM* -vvv- NO Pity for the LAZY - 86-44)
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