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Share your experience with the media

I've been
hearing from people who have recently gotten health insurance that some things
they thought were included in their plan as preventive measures were not. For instance, one person
said he went in for his annual wellness visit with his physician, which he
thought was covered -- it was, but he asked a question about pain he had in his
knee, and was charged for that. Another patient told me he went in for a
colonoscopy, which is covered, but then a doctor removed a polyp while he was
under and charged him thousands for that.

I'm looking for people who are covered by private insurance who had similar experiences and examples they could share. 

NOTE: This is NOT a story to recount any difficulties that happen when paying for insurance -- I’m specifically looking for someone who is heading in to have one of the
prevention benefits now guaranteed without copay under the ACA—colonoscopies,
vaccinations, wellness visits, OBGYN appointments, a mammography—and how
patients are charged for anything extra that happens during that visit.

Here are the listed benefits: https://www.healthcare.gov/coverage/preventive-care-benefits/ ;

Please share your story in the discussion below!


  • It sounds like he didn't properly read the release form when he went to visit the physician.  Of course, this could happen with any type of insurance, not just ACA insurance.  I know that when I go in for the yearly physical, or a regular visit, and it is determined that I need an X-ray or blood test or something else, I go back to scheduling and my insurance situation is screened again (with any co-pay, etc.), then get the test. 

    With that said, it is a great problem with the American health care system that there is typically no price list for services, and even when there is, it is a ridiculously high "rack rate", and not the negotiated price with the insurer.  But this is not a problem with the ACA (if anything, the ACA has allowed folks to buy coverage to get those lower negotiated rates.)
  • I feel like health insurance companies think they can do whatever they want and don't follow the rules they are supposed to.  It is so frustrating because we pay high premiums every month, and on time, in order to receive health care, but they pick and choose what they want to cover.  I was told on my last policy that once I met my high deductible that 100% of eligible expenses were covered, but now they are refusing to pay some of my medical bills.  They are stating they were not medically necessary.

  • Posts: 70
    It is just so frustrating always being inundated with stories like these and how the patient always ends up losing.  It is just not the point of any of the industries that are at work here.  I think that we were all hoping for a break from these sorts of things with the new laws, but I am pretty sure that we will get the same things but just with different players in different places.
  • When you go in for a wellness visit the doctor will charge you if you even discuss anything else. I too learned this the hard way. Unless you have a really good relationship with your doctor I believe this would be the case with most. This type of insurance is basically bill for everything that is not general/prevantitve. You really have to read the fine print.
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