Monday, July 02, 2012

Free Isn't Really Free

Free annual exam. That's what we were promised. A free annual exam. As part of the Obamacare promise, Medicare beneficiaries can receive their annual physical at no charge . . . or at least, that was what we were told.                              

But if you don't follow the rules, your free annual exam could cost you $500 - $1000 or more.

First the big one.

SOME colonoscopy's are available at no charge, but you should be aware if your free annual exam was done because of a complaint or issue, or if the exam discovers polyp's, you have gone from a free colonoscopy to one costing $1000 or more.

Even a "routine" office date for your annual physical can end up with a doctor bill for $500 or more. When you arrive at your doctor's office you will probably be asked to fill out a questionnaire that runs several pages and asks if you are having problems or concerns about your health.

Be aware that a "yes" can change the coding on your exam from routine to diagnostic and your free annual exam is no longer free.

Medicare provides a 28 page booklet titled "Your Guide to Medicare's Preventive Services". Study this before going for your free annual exam.

You should also review the Preventive Services Checklist to learn what is and is not covered in your free annual exam.

Just because services are listed as part of your free annual exam in the checklist does not mean you will not be billed. Consider this from Medicare's page on the free annual exam.
You pay nothing for the yearly “wellness” visit if the doctor or other health care provider accepts assignment. If you get additional tests or services during the same visit that aren’t covered under these preventive benefits, you may have to pay coinsurance, and the Part B deductible may apply.
The visit is covered by Original Medicare (Part B) and Medicare Advantage Plans. Under the new healthcare law, the visit is now free to those with Original Medicare, and to most people with Medicare Advantage Plans, along with a number of preventive screenings and services (like mammograms and colonoscopies).
Sure makes it sound wonderful, including a free colonoscopy. Almost makes you want to call now and schedule your free annual exam, doesn't it?

After all, it IS free.

Know this. It isn't a free annual exam unless Medicare says it is free and they won't make that determination until AFTER your doctor submits your claim.

Don't get caught with your pants down. Understand the difference in free and this will only hurt a little . . .
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