A question about annual checkups...

[grioghair]

I live in Indiana.

I am employed by Kroger, and I am insured by the UFCW. I have just discovered that my health plan does not cover annual physical checkups. I guess this comes under the umbrella of "not medically necessary". I am now 50, and these checkups are becoming necessary. Is there any way around these charges, or are they pretty much carved in stone?

Thanks,

Steve

 

[porcelina68]

I live in Indiana.

I am employed by Kroger, and I am insured by the UFCW. I have just discovered that my health plan does not cover annual physical checkups. I guess this comes under the umbrella of "not medically necessary". I am now 50, and these checkups are becoming necessary. Is there any way around these charges, or are they pretty much carved in stone?

Thanks,

Steve

What type of plan do you have (PPO, HMO)?

 

[cbg]

It depends entirely on the exact wording of the policy and whether or not you can convince your doctor to call it a medical necessity AND to provide a medical diagnosis that will support the medical necessity.

Simply growing older does not make your insurance company liable for paying for a procedure that is normally excluded.

 

[grioghair]

What type of plan do you have (PPO, HMO)?

It is a PPO.

 

[grioghair]

It depends entirely on the exact wording of the policy and whether or not you can convince your doctor to call it a medical necessity AND to provide a medical diagnosis that will support the medical necessity.

Simply growing older does not make your insurance company liable for paying for a procedure that is normally excluded.

It is an umbrella term. Pap smears, routine checkups and mammograms are all listed together under the same "not covered" category. However, I have since discovered that my spouse is covered because of a pre-existing condition. (Not for routine check-ups, but for mammograms.) In fact, I have just had a colonoscopy today, and went to the trouble of finding out the coverage before the exam. It was covered, because of rectal bleeding that I had suffered earlier in the year. Some UFCW states cover routine check-ups - Ohio, for example. I guess this is decided on a state-by-state basis.

Steve