Promote Your Wellness with Preventive Services

appleheartInsurance companies cover a visit with your healthcare provider—whether it’s with a doctor, physician’s assistant, or nurse practitioner—once a year at no cost to you.

Although there are plenty of negatives to groan about in healthcare these days, this is a win! Doctors worked with legislators and for the past ten years, preventive services have been covered. At the Downtown Doctor, we invite you to take advantage of this. That’s right, you don’t have to be sick or have a medical issue or problem to see us. Bring in your supplements, vitamins, and list of questions. Together we can promote YOUR wellness.

It can get confusing and frustrating, so let me clarify why sometimes this visit incurs a copay/cost. Say you come in for the annual wellness/preventive visit. You and your provider review immunizations, order labs/other tests based on your age/risk factors (colonoscopy/mammogram/other), review medications, supplements, answer general wellness questions—that’s covered!  However, if a medical problem is introduced, assessed, and managed, that’s when you could be billed.  

For example, if you have a sore knee and want the physician to examine it, that isn’t preventative; this is a medical issue which requires assessment and a plan. Insurers use the term “separately identifiable” to describe this kind of problem. Your provider will make a list of future visits to schedule, each one focused on a problem. If patient and provider agree to evaluate and treat a problem on the same day as the preventive visit then there would be a copay/charge. That is because the problem is in addition to the preventive visit.

Clear as mud? We are used to navigating the choppy waters of healthcare so please ASK for clarification.

The Downtown Doctor is accepting new patients and most insurance plans, including Medicare and Tricare. Please call to see if we accept your plan and schedule that annual visit. Together let’s PREVENT a problem!

For women, this visit is in addition to your covered annual gynecological visit which may include a pap smear.

Other covered visits (may vary depending on your plan so, again, please ask your insurance company and us) are for screening of sexually transmitted diseases, evaluation of contraception options, school physical, and work physical.

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