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Am I the last person to find this out? I was billed for 2 visits during my "Annual Wellness Visit"; that, + an additional 15 min. office visit. I thought, this is crazy, it must be a mistake. Foolishly, I called medicare & spent an hour on the phone talking to some obtuse idiot, trying to get her to understand what I was even talking about.
The "Annual Wellness Visit" is covered in full by medicare--it's one of the great perks of medicare IMO. My deductible for a 15 min. office visit is $80.66. The medicare woman kept saying, "but Sir, do you not understand that YOU'RE responsible for the deductible?".
Me, "yes, but that's for a 15 min. office visit, that I didn't HAVE. I was there for the "Annual Wellness Visit", that has NO deductible". She refused to acknowledge that I was billed for TWO Dr. visits for the SAME visit.
Then, I called the billing office at this giant medical/hospital group near Boston (that seems expert at extracting the max. amount of $$ from patients & their ins. co.'s) where my Dr. is. After several phone calls, they finally informed me that if anything is already "wrong" with the patient, pre-existing whatever, during the "Annual Wellness Visit", then they're charged extra. How many 65 y.o. (& older people) have nothing wrong with them, at all?
Now, again, this sounded crazy to me. I was in the Dr's. office for no more than........30, 35 minutes, just answering a lot of ridiculous questions mostly: "Can you draw a clock". So I drew a clock with 12, 3, 6, & 9. The Dr. looked at it, & said, "can you fill in the other #'s?". OK. So that's how useful the "annual wellness exam" is. (I was bummed out for a couple of weeks after that, by the insinuations that I'm senile just b/c I'm 66. I know I'm getting older, you don't have to rub my nose in it.) Like I'm 6 years old: "little Woody, can you draw a clock"?
So I messaged the Dr., still thinking the charge for the additional 15 min. office visit might be a mistake. I got this back:
Hi ---------, with annual wellness exam, if anything is discussed other than just the basic screenings that the annual wellness covers, it is billed separately as to address the specific issues. Patients are given this information upfront when they are checking in for the annual wellness. If you were not given this paper explaining this, let us know but it is a standard practice.
First, I wasn't "given a paper explaining this". Or I wouldn't have spent two frustrating hours of my life trying to straighten out a billing error (I thought). Second, the Dr. spent a few minutes my about my BP--that's my one pre-existing condition; hence the double-billing. Wouldn't blood pressure be part of the "annual wellness exam"?
I know I have to just let it go & pay for the extra Dr. visit (when there was only one--in any normal definition of reality). It's not the $80--I can pay it--it's that I wasted so much time b/c I wasn't told about it. And I wonder how many "seniors" (I hate that term) on medicare really would have trouble affording it......
What you had was two different services, not two different visits.
The Medicare "wellness" visit has a very specific definition. It is for information gathering and planning preventive care. The book you get from Medicare every year explains it for you.
It is not for management of ongoing medical conditions.
It is not for discussing new problems.
If there is a service provided at the time of the wellness visit that is completely separate from the components of the wellness exam, that will be charged for and copayments and deductibles apply.
From the link above:
"However, you may have to pay coinsurance, and the Part B deductible may apply if:
Your doctor or other health care provider performs additional tests or services during the same visit.
These additional tests or services aren't covered under the preventive benefits."
Last edited by suzy_q2010; 09-15-2017 at 03:34 PM..
Sort of - we've had posts on this issue for years - both Medicare and ACA. SuzyQ explained it well. The so-called free preventive under the ACA is also subject to additional charges if there is any new issue discovered or management of a pre-existing condition - i.e., prescription refill. In short it is more the norm than not to have a "wellness" or "preventive" office visit incur additional charges.
Last edited by Ariadne22; 09-15-2017 at 03:47 PM..
Is the "Annual Wellness Visit" that is paid for by Medicare the same thing as an annual physical exam, which I thought was free on Medicare.
We both went for an annual physical exam and it took six months to finish paying for that visit, what with "lab this" and "analysis of lab work" that, I was horrified that we finally ended up paying about $150 each for this "free" annual exam. I guess we got more than was specified on the Medicare exam, but no one bothered to tell us that at the dr.'s office. This is what upsets me.
Now I have to go in specifically to have a blood sample drawn on Monday morning, for which they have nothing to do but take the sample and send it off to the specialist, and what do you bet I get charged some kind of doctor's visit for that? I'm waiting to see.
Is the "Annual Wellness Visit" that is paid for by Medicare the same thing as an annual physical exam, which I thought was free on Medicare.
We both went for an annual physical exam and it took six months to finish paying for that visit, what with "lab this" and "analysis of lab work" that, I was horrified that we finally ended up paying about $150 each for this "free" annual exam. I guess we got more than was specified on the Medicare exam, but no one bothered to tell us that at the dr.'s office. This is what upsets me.
Now I have to go in specifically to have a blood sample drawn on Monday morning, for which they have nothing to do but take the sample and send it off to the specialist, and what do you bet I get charged some kind of doctor's visit for that? I'm waiting to see.
No, it is not the same as an annual physical exam. See the link in my previous post.
You may be charged for collecting a blood sample. It is a service that incurs labor and supply expenses, and the office is not paid for doing the test. Larger offices where the actual lab has a tech in the office may not charge.
OP; I hear your frustration and there is plenty in the medical world.
If it were me and I went around and around like you say you did and if you have to pay a deductible and IF you are on a lower income, what I would do is make payments.
If I never stepped into another doctor's office I'd be one happy person. If I didn't have to show my face annually for a check in and refills for thyroid and bp meds, I'd never go...I'm healthy and spend my $$$ on supplements.
I read topic after topic on the insanity of American medical costs, Why Americans continue to tolerate this type of system is beyond comprehension to this Canadian and no doubt to the rest of the world.
I agree. The health care system is nothing but a massive cash grab. I am privy to several doctors salaries and if people knew what they were -- really - with bonuses mixed in, they would riot.
What you had was two different services, not two different visits.
The Medicare "wellness" visit has a very specific definition. It is for information gathering and planning preventive care. The book you get from Medicare every year explains it for you.
It is not for management of ongoing medical conditions.
It is not for discussing new problems.
If there is a service provided at the time of the wellness visit that is completely separate from the components of the wellness exam, that will be charged for and copayments and deductibles apply.
From the link above:
"However, you may have to pay coinsurance, and the Part B deductible may apply if:
Your doctor or other health care provider performs additional tests or services during the same visit.
These additional tests or services aren't covered under the preventive benefits."
Well, I was billed for a "15 min. office visit". Plus, like you say, "The Medicare "wellness" visit". Aren't both of those commonly called "Dr. visits"?
And the difference between an "annual physical exam", & a "wellness" visit? This all seems like very clever slicing & dicing of semantic terms. It's like something out of "Catch 22". or maybe "Dr. Strangelove": "But Dr. Strangelove, that sounds insane! How can......."
BTW, what the ---- is "information gathering"? "Information gathering"? To find out if I can draw a clock?
suzy_q2010, I'm not railing at you; & I know that you're just being helpful. I also know how screwy the American medical "system" is. I started learning--the hard way--about 25 or more years ago that patients have almost no power, or rights, or say in much of anything. Dr's., & hospitals, & ins. companies have almost all the power. It's like: aren't I hiring you--paying you--? But I just have to "obey" anything they say ("or else")--& be charged anything under these bizarre rules they've cooked up?
Now my "PCP" is forcing me to go to a cardiologist, b/c of my slightly high BP. I'm beyond apprehensive about that. (And will medicare pay for cardiologist visits?) I can't even imagine how many times he'll force me to go back for "followup visits", or bizarre test procedures, etc. Or all of the clever billing tricks.
Plus which, I'm getting stressed out, which can't be good for my BP, b/c of all the BS from Dr's, & billing offices, & worrying about all that. And there's not even much wrong with me. And I'm 66--retired--I should just be enjoying life (as much as possible)--not living in fear of Doctors & what they're going to do to me, or force me to do. I don't need this......
OP: I agree they really put the fear in people. That's why I work to stay away from them...Do you take BP meds now? This BP industry is so corrupt as I've been working on this issue for many years....and I do take a couple meds and probably got me hooked for life as they do, but also along with the meds I take a otc BP med for extra protection. Buy it on amazon and feel good about using it along with the meds.
One has to be creative too and NOT follow all the medical masters and their fear.
There are MANY choices to keep the heart healthy. And not end up on drugs and a sick heart.
One can make themselves "sick" with what goes on in the medical industry more today than ever. Work to keep yourself healthy, everything is at our fingertips for the asking.
Last edited by jaminhealth; 09-16-2017 at 11:14 AM..
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