? For anyone with ghi through the nypd

I just found out their was a max on well visits for the kids...so my dd last visit got denied and it only looks like they covered for her shots...so it looks like I'll have to pay for her next two visits until she turns 2 and then they will only cover 2 a year...this is going to get expensive out of pocket wise with 2 kids, just had my ds Monday...my question is do u find your pediatrician will work with you on the out of pocket expense or is it worth paying extra through the nypd to up our plan for better coverage?

Re: ? For anyone with ghi through the nypd

We have GHI through NYPD and all DD's well visits were covered. Never had an issue

? For anyone with ghi through the nypd

We have ghi through the city to (dh is sanitation) and I never had an issue with well visits. We went at 1,2,3,4,5,6,8,10,12,15,18,21,24,30,36 months (with DS, DD Is only up to 15) and never had any issues.

? For anyone with ghi through the nypd

The visits that GHI doesn't count as "well visits," I've only had to pay the $15 co-pay since they counted as just regular old office visits. That was for a few extra well visits in the first 2 years that my pediatrician requires that GHI didn't cover.

Did you have to pay more than the office visit co-pay for the non-covered well visits? And for labwork we always had to pay the $15 co-pay (first to the doctor, then to the lab), regardless of whether it was for a covered well visit or not, so I assume you're not concerned about that.

Anyway, if you only have to pay the $15 co-pay for the occasional extra well visit, seems like it would be more expensive to pay for higher coverage out of every paycheck.

It's interesting that your pediatrician does more than two well visits per year after 2 years old. My pediatrician (and I assumed most) only do one per year after 2 years old. I wouldn't mind the extra visits to make sure my son is on track!

Re: ? For anyone with ghi through the nypd

Interesting, they re telling me they only cover 11 visits from birth to 24 months, then 2 visits age 2-3 and then only one visit ages three and up...I'll have to call them again and double check what's going on

Re: ? For anyone with ghi through the nypd

Re: ? For anyone with ghi through the nypd

Yikes! I thought we had the lowest GHI plan, but I guess not.

? For anyone with ghi through the nypd

We have it through the FDNY and there is a max - we had one additional well visit for each kid over the max. Sending you FM.

Re: ? For anyone with ghi through the nypd

Wow this is news to me. So far all of his well visits have been covered, we only had to pay the $15 co pay when it was not a well-visit.

Re: ? For anyone with ghi through the nypd

At my Drs office, we have 1 well/month from 1-6 months. Then every 2 months til age 1. Then 15 months, 18 months, then 2 years, and not another well until age 3.

So 11 in the 1st 24 months sounds right. I have the same GHI plan and never had a problem. If we ever went in just for shots (like the flu shot appt)- it shouldn't be billed as a well visit. Also, well visits are no co-pay. Sick visits are free.

Make sure you're not making appts early-there needs to be a full month, between the well visits in the beginning.