https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Sat, 18 Apr 2026 05:32:42 +0000 https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1782422 Fri, 25 Jul 2014 19:24:18 +0000 Sparkler 1782422@https://boards.hellobee.com/ <p>@Eko: I am in MA and also have Harvard Pilgrim and can concur! It happened to my LO once when she had an ear infection at a well visit. Oh well! </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1782198 Fri, 25 Jul 2014 16:05:38 +0000 BrandNewMom 1782198@https://boards.hellobee.com/ <p>Not to me, but to DD! I mentioned I was concerned that after I gave her a bottle she refused the breast for 6 hours during a well baby visit, and BOOM! $20 copay. That was with UHC living in MA </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1782099 Fri, 25 Jul 2014 15:10:31 +0000 Eko 1782099@https://boards.hellobee.com/ <p>I have coverage in MA through Harvard Pilgrim. When our policy renewed in June we were told that same thing that they told you regarding the difference between the standard physical and then being charged for an office visit if they diagnose something. I also tend to think that it sounds like they are also just trying to collect their money if they diagnosed you with something and didn't prescribe you anything!? I think every office tends to be different on how they code things or give you a break then others. There were many changes this year to our health policy, that could be a factor for you. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1782080 Fri, 25 Jul 2014 14:58:27 +0000 AmeliaBedilia 1782080@https://boards.hellobee.com/ <p>@MaryM: Good points. And in your analogy, you're doing extra work so get extra pay. Why shouldn't a doctor who does extra work get extra pay? </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781511 Fri, 25 Jul 2014 11:47:00 +0000 MaryM 1781511@https://boards.hellobee.com/ <p>@PurplePumps: Prescribing vitamins may very well be categorized as "preventative care." It's hard to know for sure. </p> <p>I found this language on another doctor's website, and it's similar to what my doctor has on signs "PLEASE NOTE:<br /> Any other testing: labs/referrals/ultrasound ordered based on signs/symptoms you share or are noted at the time of your wellness visit may not be covered as part of the wellness visit and you may be financially responsible."</p> <p>So it's not so much that they definitely WILL charge you for extra stuff (like TTC advice), but it's letting you know there's a chance they may. I think it all depends on how the doctor codes it. They may not record that they wrote a script for vitamins if it was super quick. </p> <p>I think it's best to know your doctors and know what they usually do. And if you're concerned, ask. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781497 Fri, 25 Jul 2014 11:42:21 +0000 Mrs. Lion 1781497@https://boards.hellobee.com/ <p>@PurplePumps: in that situation i don't think that writing a prescription for prenatals would be considered an office visit. I would think it would be more like writing a prescription for an antibiotic because i have strep throat at my well visit....I'm sure there are some grey areas in there, but they have to set limits to prevent people from abusing the system. Well care is covered without a co-pay to encourage people to stay on top of their health when they are healthy. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781477 Fri, 25 Jul 2014 11:37:10 +0000 PurplePumps 1781477@https://boards.hellobee.com/ <p>@AmeliaBedilia: @MaryM: I guess that's part of why this came as a surprise. To me "one" visit should not be billed as "two" even if something else came up (which took all of 3 seconds for my Dr to look at an prescribe something.) I can kind of understand the reasoning behind it if you had say two separate appointments, which they are making it out to be. But to me, one sessions was one session,</p> <p>So 2 years ago, I told her I was going to start TTC and she said I should take prenatals, either over the counter or prescription she said was fine. Then she said, here, I'll just write you the prescription, and just get whatever is cheaper (since I have good drug coverage). So under the new to me rules, writing a prescription would have ding me for a copay and would have complete negated the reason she wrote it for me in the first place! If I had been charged for that, I would have totally seen that underhanded and sneaky and not probably not trusted them anymore for not telling me, btw, it'll cost you $30 bucks for me to write this. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781454 Fri, 25 Jul 2014 11:31:02 +0000 psw27 1781454@https://boards.hellobee.com/ <p>I am in MA and I have 100% preventive care coverage. I don't think this has specifically happened to me, but I can say that I'm never surprised when my insurance tries to get a few extra dollars out of me for a co-pay after a visit... had a pap smear as part of my routine maternity coverage and they said that because it took place at an office visit and not a preventative care visit it was not preventative care and I had to pay my portion of it. So annoying... </p> <p>I think they should tell you if they are going to bill it separately but there is usually no way of knowing until you get the bill! </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781402 Fri, 25 Jul 2014 11:16:20 +0000 MaryM 1781402@https://boards.hellobee.com/ <p>I've never really seen it as an issue. The way I see it, if the doctor discovers an issue during a wellness visit, they could say "Schedule a follow up appointment on your way out to discuss X,Y, or Z that I discovered"</p> <p>If they're willing to spend extra time discussing it while I'm already there, I think that's a bonus. And I'm willing to pay a copay for the convenience of getting it taken care of at that time. </p> <p>It's like, if my boss gives me an assignment and a deadline, I'm going to complete the assignment in the time he asks. If, while I'm working on it, I discover other related things that need to be done, I'm going to ask for more time in order to do them...and expect him to pay me for those extra hours. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781382 Fri, 25 Jul 2014 11:08:17 +0000 TheReelDeal 1781382@https://boards.hellobee.com/ <p>That's a pretty standard insurance billing practice. If the visit strays from any "preventative care" into "diagnostic" you will be bill separately for "diagnostic" care. It's important to tell your physician you want the visit to be "preventive" just so there are no billing surprises. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781355 Fri, 25 Jul 2014 10:58:28 +0000 raspberries 1781355@https://boards.hellobee.com/ <p>@PurplePumps: I'm in MA and we have United - I've never been charged for a preventative appointment, but I don't think they've "discovered" a new illness at one yet either. That just seems so unfair and sneaky. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781235 Fri, 25 Jul 2014 10:15:53 +0000 AmeliaBedilia 1781235@https://boards.hellobee.com/ <p>It sounds like you've been getting a break before when they should have been charging you, and are no longer giving you that break. :meh: </p> <p>My doctor won't combine any problems with my wellness visit. She explained it as that you're either well (and have a wellness visit to look for other things that haven't been noticed and doing preventative care), or have a problem or problems that need addressing. Insurance specifies what a wellness visit is, and it does not include problems. If I bring up a rash, she will give me the option of either the wellness visit or the rash. She is smart to do that so no one gets surprised. That is the way insurance works and while many things insurance does don't make sense, this one is one of the few that does make sense. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781118 Fri, 25 Jul 2014 09:42:12 +0000 PurplePumps 1781118@https://boards.hellobee.com/ <p>@sorrycharlie: I think HMO's require referrals. We used to have copays for preventative visits with BSBC, but our company uses United now.</p> <p>@Cole: Yes, exactly! I thought that was the point of a preventative care/yearly annual too. That is exactly what my husband as I was saying, it's like we can't say anything or answer their questions for fear that answering a question a certain way is going to cost us. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781115 Fri, 25 Jul 2014 09:39:20 +0000 jessibear 1781115@https://boards.hellobee.com/ <p>I'm in Iowa and I know it's standard practice to bill a separate office visit for problems the patient brings up during a well visit. Our insurance agent actually explained this in our annual benefits meeting at my old job. I'm not sure it's well explained most of the time, though and I think most people just don't pay close enough attention to their bills when they come after the fact. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781102 Fri, 25 Jul 2014 09:36:12 +0000 Cole 1781102@https://boards.hellobee.com/ <p>I had no clue about this! So how does it work if, for example, you have a rash. If you bring it up they bill you for an additional visit but if the doctor just happens to notice it does it still get billed as a separate visit? I really thought the point of preventative care was to catch all the little symptoms that could otherwise go unnoticed. Maybe diabetes would be a better example than the rash- you come in and say you're thirsty all the time, tired and hungry but you bring it up vs. the doctor asking questions because of your family history, what then? It seems awful to me that preventative visits are basically discouraging people from discussing their health concerns if they can't afford the copays and extra labs- what's the point? </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781075 Fri, 25 Jul 2014 09:27:53 +0000 sorrycharlie 1781075@https://boards.hellobee.com/ <p>@PurplePumps: our health ins (BCBS) is through MA. We have always had a co-pay ($20) for all preventative health visits - us and LO. We have never gotten an additional bill however. I wonder if it has to do with the type of insurance? I'm not even sure what "type" we have, I do know I do not need referrals for specialists (is that what differentiates ppo/HMO?) </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1781039 Fri, 25 Jul 2014 09:18:20 +0000 PurplePumps 1781039@https://boards.hellobee.com/ <p>Wow, I'm actually shocked to see that this is normal! </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1780831 Fri, 25 Jul 2014 08:30:40 +0000 LemonLong 1780831@https://boards.hellobee.com/ <p>@PurplePumps: I'm in Colorado.</p> <p>The preventative visits have guidelines on what is covered under them, so when you go to one the doctor should be taking the same steps as all other doctors billing for the same code- so like an annual prostate exam would be done for a guy, but adding in extras like an ingrown toenail or something wouldn't be coded under that even if it was the same visit. The annual visits are there to catch major red flags like prostate cancer, diabetes, high blood pressure etc and to help patients establish repertoire with their doctors so that they are more comfortable going to them for other issues. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1780814 Fri, 25 Jul 2014 08:23:41 +0000 MaryM 1780814@https://boards.hellobee.com/ <p>@PurplePumps: I'm in VA</p> <p>I think if the doctor notices something in a well visit, then it's covered (and that's the purpose of them being free...so that the doctor can keep track of any signs of illness the patient might not be paying attention to). But I think they charge when people bring up issues because they don't want the free visits to be abused. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1780797 Fri, 25 Jul 2014 08:19:12 +0000 PurplePumps 1780797@https://boards.hellobee.com/ <p>@MaryM: @LemonLong: What states are you guys in?</p> <p>@LemonLong: I never saw it as abusing the system. Honestly if it wasn't covered, I would never have bothered going in and just deal with my little issues. I thought the point of making it covered was to get people in TO discuss these issues and treat it before it becomes a bigger problem which would result in even larger cost of treatment for insurance companies. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1780782 Fri, 25 Jul 2014 08:15:54 +0000 LemonLong 1780782@https://boards.hellobee.com/ <p>Our pediatrician had us sign a notification that if we brought up any any other issues during a wellness check visit that we would be charged for a separate visit. I think it's common so people don't try to abuse the system by using the free preventative check ups for other ailments. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1780779 Fri, 25 Jul 2014 08:14:25 +0000 Mrs. Lion 1780779@https://boards.hellobee.com/ <p>My pediatrician has a notice on the wall that states that any illness discussed during a well baby check will be billed as a separate office visit. It has never happened to me before, but i guess its standard here in NC too. </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1780772 Fri, 25 Jul 2014 08:11:30 +0000 MaryM 1780772@https://boards.hellobee.com/ <p>I'm not in MA, but I know that at my OBGYN they have signs up EVERYWHERE indicating that if you're getting an annual, you need to notify them ahead of time if you have other issues you want to address because that is coded as a different sort of visit. I've been seeing the signs for a couple of years, so I'm not so certain it's "new" </p> https://boards.hellobee.com/topic/if-you-have-100-coverage-for-preventative-care-esp-ma-bees#post-1780760 Fri, 25 Jul 2014 08:08:20 +0000 PurplePumps 1780760@https://boards.hellobee.com/ <p>Under our insurance plan, preventive care (one annual routine physical including routine labs) is 100% covered. My husband just saw a new doctor where they did the routine weight/height/blood and then also discussed his back pain. When the bill came, we were shocked to see that we were charged a co-pay and for the blood work. We disputed it and found out that he was charged for a "Preventative screening visit" AND and "office visit" for ONE appointment! (They had coded the blood work for the office visit which caused us to be charged, but corrected that). </p> <p>So we get some letter of explanation regarding why they can do that, which basically said that if the doctor diagnosis a new chronic condition (such as his back pain) or writes a new or updates a prescription, they can charge for an office visit which may (will) result in a copay.</p> <p>So I was pretty pissed about this, cause it has never happened to me before. I go for my annual physical, talk about problem, got prescriptions and it was always covered under the preventative care visit 100%. Until this year. I just went for my annual, got a new prescription for a rash and I was charge a separate visit requiring a copay!! </p> <p>WTH!!? So... sorry this ended up so long, but I wanted to include all the detail. But I was just wondering if this has happened to anyone else (especially those in Mass) and if this is some new thing?? </p>