There has been a lot of media and press attention lately, focused on your Wellness Exam. There are also a lot of misinformation floating around. We hope to help clear up any confusion.
It is true that under the ACA, your annual wellness exam is covered 100% by your insurance company. It is also true that your insurance company now may hold your doctor responsible for supplying details of your exam, (i.e., height, weight, blood work results) to them in order for them to reimburse your doctor.
It is NOT true that your annual wellness exam must be done by a primary care physician. Your OB/GYN falls under a dual category. We are specialists and we are most women’s primary care physician. You do NOT have to submit to a pelvic exam by the same doctor who treats your sinus infection in order to be covered.
It is true that some commonly prescribed drugs are no longer covered by some insurance carriers. Several of our patients have found out that their preferred birth control or hormones are no longer covered by their policy. Unfortunately, they found this out at the prescription counter when asked to pay for their medicines. Please understand that it is not information that is available to us prior to writing a prescription. To avoid costly surprises, we recommend that you call your carrier and get a list of approved medicines before coming to our office for your exam. Then you and your TWC physician can discuss the best alternatives for you and make a plan that both covers you medically and doesn’t pose a financial hardship.
We appreciate your patience as we are all learning to navigate this new, and at times confusing, healthcare landscape. Our first priority has always been, and will continue to be, offering first class healthcare to you, our patient. To see what a typical wellness exam covers we have compiled a chart here.