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Discussion: Co-pay

in: anniemac; anniemac > 2020-07-29

Jul 29, 2020 12:24 PM # 
For most insurances that visit should be free under preventive care... but I've had times when I was incorrectly charged co-pays and received the money back eventually (sometimes years later a check just showed up)
Jul 29, 2020 1:30 PM # 
Possibly a deductible you haven't yet met for the year?
Jul 29, 2020 4:37 PM # 
I have a large deductible, but it usually doesn't apply with regard to certain services (annual physical and well-woman checkup). I believe that's part of the ACA so the insurance company shouldn't matter.
Jul 29, 2020 4:49 PM # 
I assume your doctor is in your plan's 'network'.

Did the visit include cervical cancer screening (pap smear or DNA test)? Have you had one in the last 3 (pap) or 5 (DNA) years? If yes and yes, it's possible that (ACA minimum rules) you are not covered. Preventative services for women that shouldn't require a co-pay:

Providers can cover more, though. Depends on your plan.

And good tips at Bedsider.ORG:
  • make sure to say you're scheduling a "well-woman visit"
  • if you were inappropriately charged a copay, contact the National Women’s Law Center’s hotline 1-866-745-5487 or via email at to let them know what’s going on and see if they can help.
  • Jul 29, 2020 5:28 PM # 
    Wow! Thanks guys! I got a message from Penn Medicine ... credit card NOT CHARGED for appointment. YAY! Also, I really really liked the doctor and she wanted my business cards to refer her older patients to a yoga teacher with experience teaching older bodies. It all worked out...but good info to have, in case this happens again.
    Aug 2, 2020 5:12 PM # 

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