What's the deal with..

... doctors and co-pays?

Okay, we're gonna get a little off track for the new year here... but what else is new... when I get side tracked?

So what's the deal with doctors and co-pays?

More specifically, what's the deal with going to a wellness visit and ending up having to shell out money?

Okay, let me explain...

I was talking to some people at home and away, and they all say the same thing: Why, when you go to your doctor (any doctor) for a wellness visit (physical). it's free. Yet, if you bring up any problem(s), it becomes an actual doctor's visit and you have to pay for the appointment?

Break it down a little more...

You go for your yearly physical with your general practitioner (internist, whatever). It's the kind of appointment where they height and weight you. Already had you do blood work, so they're going to go over it with you. Perhaps tell you about medications for whatever is found in the work up or the fact you've got to do something with your weight. 

However...

The second you bring up something regarding medication or an ailment that's been bothering you, this freebie visit not turns in to a paid visit, as you're bringing up health challenges that is not normal to the visit you're in. 

I know someone who brought up a change in his (basic) allergy medication. He was at his physical and asked about using some over the counter meds as what he was being prescribed wasn't really working for him. He did some research on what seasonal allergy medications are more readily available, and wanted to know if that would conflict with any thing else he's taking. 

Well.. the doctor explained some things about the uses of the store bought meds versus what the guy is already taking, and wouldn't you know it, he walked out having to pay his co-pay. All because he raised questions about seasonal allergy medications. The doctor didn't bring it up, the guy did. Had he not asked, he wouldn't have been charged the visit.

I know someone else, who went to have their yearly, and brought up the fact they had some sporadic pain in an area. It wasn't every day, but it wasn't rare either. It came and went, and they don't know why. Doctor did another one over, asked pertinent questions, sent the person on their way out and the person paid their co-pay. I don't remember the answer to the pain questions, so I'm not going to go there. 

But... 

If you're going to go have a doctor's appointment and it's supposed to be a yearly exam where you go over anything or everything, why do you have to pay for it, if you end up asking questions relating to your health? The whole basis of the visit is a health visit. Why can't everything be (literally) put on the table and talked about, and still be covered? 

Yes, visits and conversations are coded differently for insurance purposes. I understand that. I got caught up into quite the few coding problems in the past decade. So trust me... I'm well familiar with insurance challenges. 

But still. Insurance is allowing you one free visit a year. And it has to be a year and a day later (or longer) to qualify for that visit. So if you're going to it and you want to bring something up, it shouldn't cost you extra because you spoke about a health issue. 

I mean hell, I had an appointment once, and all the doctor did, was talk about comic books. I'm not a fanboy and into all the sub genres or anything relating to comics. Sure, I know some of the characters, I've seen a movie or two, but I'm not fawning over any of it. I can barely keep up the conversation with one of my friends who will randomly start a Loki conversation with me (she lubs him). So when my doctor started a 40 minute trope of a monologue about X-Men and Batman and all MCU and DC characters, I'm like "this dude's gonna make me pay for this shit". Lo and behold, I had to pay my co-pay and we only talked for 2 minutes about my blood work. I was mad as hell. 

To top it off, that was the first and last time I saw him. I had recently changed doctors (because the one prior left the practice) and this guy accepted me. Every year since, for both wellness and otherwise visits, I've seen the nurse practitioners. I've yet to see him again. 

With all the health problems in our world today, among other worldly challenges, I ask again: What's the deal with going to the doctor for a wellness visit, mentioning a problem that's out of the spectrum of the visit, and you have to pay for it? Literally and figuratively? AND... the "wellness visit" you were there for... gets put back on record as not having it. As you're now having a doctor's visit, your wellness / physical goes back on the books for you to come back and do over. 

Help me figure that one out...

Stay healthy

Cherers;