Women's well check up

[leahjade]

I could be wrong but I thought it was a law that women are allowed 1 well care visit per year at no charge included on all health plans. I just switched insurance companies and was billed for my visit. Anyone know about this?

 

[Marionnette]

I could be wrong but I thought it was a law that women are allowed 1 well care visit per year at no charge included on all health plans. I just switched insurance companies and was billed for my visit. Anyone know about this?

Nope. You were wrong. Insurance must cover rountine gyn exams and testing under the same rules they apply to all wellcare visits irregardless of gender. If you got to pay copays or meet a deductible for other well visits then you got to pay the same for routine gyn.

 

[Drew Sailbum]

Insurance regulations vary on a state-by-state basis. If your states has not mandated this benefit for health insurance plans then it won't automatically be covered.

 

[RitaE]

I believe that Illinois State law dictates Pap Smears and Mammograms, not sure of the exact schedule though.

The thing is ... self insured plans aren't governed by State Law but Federal Law and I don't have a clue what Federal Law requires and it is probably all changing soon anyway.

 

[PrincessSuzanne]

It also varies by employer, or at least it does with mine. Our old plan I still had to pay a $35 copay, with our new plan, they pay at 100%.

Suzanne

 

[Tink-aholic]

I could be wrong but I thought it was a law that women are allowed 1 well care visit per year at no charge included on all health plans. I just switched insurance companies and was billed for my visit. Anyone know about this?

Insurance plans are like snowflakes. I could have the same insurance as you and have completely different coverage. The only one who has the information as to whether or not your visit should be covered is you. Look in your policy benefits book or look up your benefits online. It is extremely common for insurance companies to deny something they should cover just to see if anyone will catch them. If they are supposed to pay for it, don't let them get away with not paying. However, if you are supposed to pay for it, then your doctor deserves the money as soon as possible.

 

[erincon23]

I believe that Illinois State law dictates Pap Smears and Mammograms, not sure of the exact schedule though.

The thing is ... self insured plans aren't governed by State Law but Federal Law and I don't have a clue what Federal Law requires and it is probably all changing soon anyway.

I just called Blue Cross, our insurance provider -- if you're getting a routine mammo and it's billed that way, no copay or deductible. But if you're going because of a suspected problem, it goes under your deductible. Doesn't make much sense, but there it is (at least in Illinois). I've been putting it off partly because I can't afford it -- but now I can, so I'm making my appointment today.

 

[miknsusn]

Has it been a full year? I know my gyn office is meticulous about knowing when your last well exam was because BCBS doesn't pay if you are even a day early. If you went last year on Aug. 27 and this year on Aug. 26, BC in AL at least, wouldn't cover your visit.

 

[SleepyatDVC]

I could be wrong but I thought it was a law that women are allowed 1 well care visit per year at no charge included on all health plans. I just switched insurance companies and was billed for my visit. Anyone know about this?

I just switched insurance plans and 1 well care visit per year at no charge IS included on both the old and new plans. HOWEVER, my OB-GYN does NOT participate in my new plan. So, I need to switch to a doctor that does participate in my new plan or pay OOP to continue seeing her.

I knew that before switching plans.

Good luck figuring out your plan.

 

[Ava]

I just switched insurance plans and 1 well care visit per year at no charge IS included on both the old and new plans. HOWEVER, my OB-GYN does NOT participate in my new plan. So, I need to switch to a doctor that does participate in my new plan or pay OOP to continue seeing her.

This. I've had to "break up" with doctors I really liked when switching insurance providers.

OP, did you check that your doctor takes your new plan before going in for the visit?

I also always check the insurance website's provider listings & specifically ask any doctor if they are IN NETWORK for my plan. I got burned once because I just took a co-worker's recommendation for a dentist & didn't double check myself that they were in-network for my dental plan. Turns out that they took my insurance, but were not in-network. I didn't find this out until after I'd gone in for a cleaning & then in again for a filling; I think my bills were almost $200 because they were out-of-network. If they'd been in-network I'd have owed a fraction of that. Live & learn...

 

[disneyxo]

As previous posters have stated, it depends on your plan of insurance AND what state you live in. For instance FL has a state mandate that preventive mamograms are paid at 100% even if your major medical plan does not cover mamograms. Other states have a mandate that they are covered but they are covered the same way any other service is covered under plan. So if you have a copay on other services you would have a copay on the mamogram.

 

[disneyxo]

I could be wrong but I thought it was a law that women are allowed 1 well care visit per year at no charge included on all health plans. I just switched insurance companies and was billed for my visit. Anyone know about this?

Does your bill show that the claim was submitted to your insurance company? Some providers will automatically send out a bill prior to receiving the insurance payment.

 

[si-am]

Mine allows for one a year. My insurance refused to pay once when it had only been 358 days since my last appt. They won't pay for it until after it has been 365.

 

[NewCrew42]

My co-pay used to be $35.00 for the early check-up. This past year, it changed to $20. This is the same co-pay I have for my primary doctor.

 

[swilshire]

My children get free well care, but I pay normal copays and deductibles for mine.

Sheila

 

[Dismom55]

This is all very interesting. My insurance is a $20 co pay for adults and $10 for kids, period. IF a PPO, if not a PPO, then it gets rediculous, so I always check and recheck as doctors leave PPO, I switch then as I am not about to pay the premiums I pay and still have to pay a lot out of pocket.

 

[pantherlj]

I could be wrong but I thought it was a law that women are allowed 1 well care visit per year at no charge included on all health plans. I just switched insurance companies and was billed for my visit. Anyone know about this?

The new law Obama signed will give "free" preventive care on health insurance policies starting after Sept 23rd when the policy renews. If your policy renews each January, your benefits start then. If you policy renews in July, it will start then.

Here is a list of services

http://www.healthcare.gov/law/about/provisions/services/lists.html