Preventative Care Visit


What is a Preventive Care Visit:

  • Your Preventative Care Visit (Physical) includes a routine physical exam, immunizations and services such that have been defined by the Patient Protection and Affordable Care Act.
  • For a growing number of health plans, insurance providers will no longer be able to charge a copay, deductible or coinsurance for preventative services.
  • Please be aware that if you have other health issues, your insurance may require Family Health Center to bill a separate office visit resulting in a copay or coinsurance.
  • Check with your insurance company about what preventive services are covered by your plan. 

What should I expect at my Preventative Care Visit:

When you check in you will be asked to fill out a Preventative Care Questionnaire.  The nurse will review the questionnaire with you along with asking you questions about your health, exercise habits, taking your blood pressure and measuring your height and weight. The Provider and/or nurse team will recommend screenings that you may be due for such as labs, mammogram, colonoscopy, eye exams, etc. Your provider will talk with you about staying healthy, your goals and give you advice on how to achieve your goals.  We believe that prevention is key to a healthy life and your Care Team is here to help.

 

Copay or No Copay:


"HIDDEN COPAYS" Even if a preventive test or screen is fully paid by insurance, you may still have a copayment or co-insurance for the doctor's office visit.  That is, the preventive care is free, but the doctor's visit is not.

  • Your Preventative Care Visit (Physical) which includes a routine physical exam and immunizations does not require a copayment.
  • If you discuss symptoms of acute or chronic diseases at your Preventative Care Visit (Physical) it is considered "diagnostic" and you will most likely be required to pay a copayment or co-insurance.
  • When patients come to see their health care providers for a Preventative Care Visit (Physical) they should expect the possibility that both preventive care and acute problems may be addressed during the same visit.  Because of this a copayment/coinsurance may be required.

ExampleLet's say you make a doctor's appointment specifically for a preventive service or test (Preventative Care Visit/Physical), but during the course of the visit you are treated for an unrelated problem, like an injury or changes in your diabetes medication.  For this visit you would be required to pay the copayment/co-insurance for the office visit.

Reasoning behind the changes in coverage:

The Patient Protection and Affordable Care Act, passed on March 23, 2010 changed regulations.  For a growing number of health plans, insurance companies will no longer be able to charge a copay, deductible or co-insurance for preventative services.  Despite these new regulations, there remain a lot of questions about what qualifies as preventative care.  Because of this confusion we encourage you to check with your insurance company about what preventative services are covered.

 

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Pinegrove Medical Center
606 N. Third Ave., Ste. 101
Sandpoint, ID 83864


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Fax 208-263-4580

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