Most insurance plans will cover a Preventive Exam (also often referred to as a Routine Physical) once a year as a benefit to their members and is often encouraged by employers and insurance companies.
A Preventive Exam is a yearly appointment intended to prevent illness and detect health concerns early. This involves screening a patient’s health risks which will include a questionnaire, brief exam, and ordering labs if deemed appropriate by the provider.
Regular Medicare does NOT cover the typical Preventive Exam. Medicare provides the Annual Wellness Visit for their members which is essentially a questionnaire – a conversation between the patient and provider.
If labs are ordered, it is the patient’s responsibility to ensure the lab is in-network with his/her insurance and what is covered.
In a Well Woman Exam, you may receive a pap smear. Please note that the collected specimen will be sent outside of our office to Summit Pathology for results.
It is possible to have both preventive and non-preventive services in the same visit (Preventive Exam and an Office Visit). This means your visit satisfies coding requirements for both types of visits during one appointment. Please remember when discussing issues outside of the preventive exam, this is an additional service provided and will therefore incur an additional charge where routine copays and deductibles will apply.
At Rocky Mountain Family Physicians, we try our best to educate our patients and provide the highest quality of care. If you have questions on what is appropriate to discuss during your appointment, please address this with your provider.