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PitterPatter11
Baby Boy is Here!
Member since 5/11 7635 total posts
Name:
Momma <3
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Well visits
I thought well visits had no copay according to the new healthcare laws. I know this might be a plan specific question, but I thought it was the case for all plans. My plan is not grandfathered in.
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Posted 5/9/16 5:10 PM  |
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pumpkinmom
LIF Adult
Member since 5/12 2912 total posts
Name:
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Well visits
I think there is a schedule of covered visits. So, if your Dr wants more, like for weight checks, they aren't covered. And, my office always tells me to book after the date (if it's a 2 month visit, they have to be at least 2 months, not a day less).
ETA - I don't have any copays on my plan, but I have a deductible & coinsurance and don't get charged anything for the normal well visits.
Message edited 5/9/2016 7:12:39 PM.
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| Posted 5/9/16 7:10 PM |
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SLPRunner
LIF Adult
Member since 12/13 1101 total posts
Name:
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Well visits
My pediatrician posted a notice recently stating that if they make any sort of diagnosis during a well visit that could be considered a sick visit event (like the doctor discovers an ear infection or something like along those lines). I think it said something about it being a new regulation or law but I'm not positive.
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| Posted 5/9/16 7:17 PM |
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PitterPatter11
Baby Boy is Here!
Member since 5/11 7635 total posts
Name:
Momma <3
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Re: Well visits
Posted by SLPRunner
My pediatrician posted a notice recently stating that if they make any sort of diagnosis during a well visit that could be considered a sick visit event (like the doctor discovers an ear infection or something like along those lines). I think it said something about it being a new regulation or law but I'm not positive.
Thanks! Ours was a legit well visit. Height, weight, head circumference, lead test - that's it - I think a standard 2 year visit - nothing special. I am going to call tomorrow to get more information, but they were closed by the time I got the mail today.
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| Posted 5/9/16 8:47 PM |
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loveus
LIF Adolescent
Member since 9/13 684 total posts
Name:
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Well visits
I pay for well visits and that's bc my husband has sucky insurance. It's the way his insurance plan is set up and I also have to pay a deductible.
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| Posted 5/9/16 9:11 PM |
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Hopefulmama
LIF Adult
Member since 4/14 1014 total posts
Name:
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Re: Well visits
Do you have magna care? There's a co pay for every visit with magna. Also if you have a very low co pay, like $10 or so, sometimes you have a copay for well visits. It's unusual but not unheard of.
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| Posted 5/9/16 9:27 PM |
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SLPRunner
LIF Adult
Member since 12/13 1101 total posts
Name:
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Re: Well visits
Posted by PitterPatter11
Posted by SLPRunner
My pediatrician posted a notice recently stating that if they make any sort of diagnosis during a well visit that could be considered a sick visit event (like the doctor discovers an ear infection or something like along those lines). I think it said something about it being a new regulation or law but I'm not positive.
Thanks! Ours was a legit well visit. Height, weight, head circumference, lead test - that's it - I think a standard 2 year visit - nothing special. I am going to call tomorrow to get more information, but they were closed by the time I got the mail today.
Could be a billing mistake. You call your insurance company too to confirm the policy. I usually get better informed that way than asking the doctor's office. But I guess like other posters said, it is not unheard of to have a co-pay for a well visit.
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| Posted 5/9/16 9:29 PM |
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Hofstra26
Love to Bake!
Member since 7/06 27915 total posts
Name:
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Re: Well visits
I have a high deductible plan (NO co-pays) and we don't pay anything OOP for scheduled well visits for both us and the kids. 
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| Posted 5/10/16 7:30 AM |
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JDubs
different, not less
Member since 7/09 13160 total posts
Name:
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Re: Well visits
we have no co-pays for well visits, but, if we exceed a certain amount of well visits then we have to pay.
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| Posted 5/10/16 9:41 AM |
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ali120206
2 Boys
Member since 7/06 17796 total posts
Name:
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Well visits
We have no co-pays for well visits but, we do have copays for certain tests that they do at Well Visits (we have GHI). I had to pay $30 for my 6 year old's last well visit since they now charge a copay for a health assessment (when you fill out the forms scoring the development) and a hearing test (which I knew about).
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| Posted 5/10/16 10:12 AM |
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jams92
Member since 1/12 6105 total posts
Name:
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Re: Well visits
you shouldn't have a copay for well visits...but if you go before you are due you may have to pay (for example if it is a 2 year well visit you have to go after their actual birthday)
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| Posted 5/10/16 10:56 AM |
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loveus
LIF Adolescent
Member since 9/13 684 total posts
Name:
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Re: Well visits
Posted by jams92
you shouldn't have a copay for well visits...but if you go before you are due you may have to pay (for example if it is a 2 year well visit you have to go after their actual birthday)
No true. All my appointments are after dc birthday and we still have co-pays. I get statements and they are all billed as well visits.
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| Posted 5/10/16 12:01 PM |
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LuckyStar
LIF Adult
Member since 7/14 7274 total posts
Name:
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Re: Well visits
Posted by pumpkinmom
I think there is a schedule of covered visits. So, if your Dr wants more, like for weight checks, they aren't covered. And, my office always tells me to book after the date (if it's a 2 month visit, they have to be at least 2 months, not a day less).
This. As long as you're not adding extra visits you should be covered. I used to work in a pediatrician's office years ago and we would come across this when parents would spread out vaccines. Whatever was done during the well visit was fine but if they came back because they didn't get the recommended number of vaccines at their well visit they had to pay out of pocket for the extra visits (not for the vaccine itself, for the actual visit).
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| Posted 5/10/16 6:05 PM |
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kn2011
LIF Adolescent
Member since 10/10 537 total posts
Name:
K
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Re: Well visits
Some insurances have copays for wellcare.. they are not common.. but it happens.
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| Posted 5/10/16 9:21 PM |
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soontobemommyof2
My boys...my everything <3
Member since 4/15 3635 total posts
Name:
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Re: Well visits
I still have to pay copays for well visits 
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| Posted 5/10/16 9:53 PM |
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Lara&Aidansmommy
For mom i miss u ETC ILOVEU
Member since 3/07 13921 total posts
Name:
ETC I LOVE YOU
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Re: Well visits
Posted by soontobemommyof2
I still have to pay copays for well visits
Me too
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| Posted 5/10/16 9:54 PM |
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soontobemommyof2
My boys...my everything <3
Member since 4/15 3635 total posts
Name:
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Re: Well visits
Posted by LuckyStar
Posted by pumpkinmom
I think there is a schedule of covered visits. So, if your Dr wants more, like for weight checks, they aren't covered. And, my office always tells me to book after the date (if it's a 2 month visit, they have to be at least 2 months, not a day less).
This. As long as you're not adding extra visits you should be covered. I used to work in a pediatrician's office years ago and we would come across this when parents would spread out vaccines. Whatever was done during the well visit was fine but if they came back because they didn't get the recommended number of vaccines at their well visit they had to pay out of pocket for the extra visits (not for the vaccine itself, for the actual visit).
I spread them out too, we get 1 every 6 weeks, I wonder if that's the reason why they always collect a copay from me.
Message edited 5/10/2016 9:56:59 PM.
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| Posted 5/10/16 9:56 PM |
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LuckyStar
LIF Adult
Member since 7/14 7274 total posts
Name:
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Re: Well visits
Posted by soontobemommyof2
Posted by LuckyStar
Posted by pumpkinmom
I think there is a schedule of covered visits. So, if your Dr wants more, like for weight checks, they aren't covered. And, my office always tells me to book after the date (if it's a 2 month visit, they have to be at least 2 months, not a day less).
This. As long as you're not adding extra visits you should be covered. I used to work in a pediatrician's office years ago and we would come across this when parents would spread out vaccines. Whatever was done during the well visit was fine but if they came back because they didn't get the recommended number of vaccines at their well visit they had to pay out of pocket for the extra visits (not for the vaccine itself, for the actual visit).
I spread them out too, we get 1 every 6 weeks, I wonder if that's the reason why they always collect a copay from me.
These aren't copays, these are the full out of pocket cost of the visit. The insurance won't cover the extra visits at all.
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| Posted 5/10/16 9:58 PM |
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