Annual physical and a high deductible plan

[utrecht]

Quote:

Originally Posted by Meadbh This: Annual physical exams may not be necessary after all | Lifestyle from CTV News

Last year at the insistence of co-workers, I had my first physical since I left the Army 25 years ago. I'm in overall pretty good shape (other than my joints) and Ive been to the doctor plenty for back issues and things like that. My blood pressure is always perfect and I have no serious heath issues in my family so I see no point in annual physicals. My physical showed just what I thought. Im good to go.

[athena53]

I guess I should appreciate my primary care doc and the lab that did my bloodwork. I signed a consent form for an extra test that wasn't a standard part of the no-cost checkup (it was under $50). When I brought up an issue that delicacy forbids me from mentioning he added a prescription for Premarin cream. There was no additional charge (although the prescription itself was insanely expensive).

[John Galt III]

My primary care doc says he won't write my prescriptions for Synthroid (for thyroid problem) unless I have an annual physical. Which is OK with me. And I like getting the annual blood tests done which lately have strayed into the "out-of-range" for a couple items like glucose and calcium. The blood tests are supposed to be 100% paid for, but, as another poster mentioned, there is an annoying extra charge tacked on ($5.75) for the actual drawing of the blood, which I have to pay for. Next tine they will charge me $6.33 for use of chair in waiting room?

[Cobra9777]

I have a HDHP, but not ACA. It's Megacorp-subsidized, post-retirement, pre-Medicare, BCBS. I see my primary-care doctor once per year for an annual "wellness" check-up, and usually everything is 100% covered. I don't recall ever paying any out-of-pocket fees for those visits, although it's not unusual to have a follow-up visit as a result of the wellness check-up, usually related to adjusting my blood pressure medication.

He rotates the lab work associated with the annual check-up to include different tests every year and we discuss all the results in detail. Occasionally one of the lab tests is not covered as preventative, but they always tell me ahead of time and the charge is insignificant. He knows my history and risks so I don't question his judgment about what is needed. He also asks me hundreds of questions and we discuss whatever I want to talk about.

I had my first colonoscopy last year and it was 100% covered as well, including removal of one polyp. We did get a bill from the anesthesiologist who had coded their service incorrectly, but one quick call to BCBS and that was resolved. Funny thing is, DW also had her first colonoscopy last year and it was the same anesthesiologist, who again coded the service incorrectly. Makes me wonder how many people pay without questioning.

[6miths]

Quote:

Originally Posted by John Galt III Just had my "annual routine physical" this past January. Talked a lot about different stuff. My health insurance website has no record of any claim being made though. Nothing in mail to me either. Interesting. Maybe the doctor learned his lesson from me a few years ago when I refused to answer any questions he had for me, and stated that I was not answering or asking any questions since I did not want to be charged more. I also stated that I thought it was sleazy to charge more money for actually trying to talk about one's health at a visit one was already paying for.

Wow!

The main, and widely unrecognized, risk of non-indicated or non-proven (often one and the same thing) visits or tests is that of false positives. For a group whose motto is supposed to be 'first do no harm', we seem to have strayed a bit from the path.

[iac1003]

Wait until you are on Medicare. DH gets a 'health screening' which I believe is mandatory annually. It is a questionnaire, an extremely brief visit with the NP or PA and some routine bloods. No talking, no doctor. I think Medicare pays pretty well for this. It is rather useless. If there is any issue an appointment must be made with the physician. Then it's not coded as preventative.


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[GTFan]

I'm not following how getting routine blood work done is useless regardless of what little else is done. Tons of stuff can be caught that way.

[Meadbh]

Quote:

Originally Posted by GTFan I'm not following how getting routine blood work done is useless regardless of what little else is done. Tons of stuff can be caught that way.

Yes, but many tests are not that accurate and there are many false positives (leading to anxiety and unnecessary investigation) and false negatives (leading to a false sense of security). The guidelines have been developed based on research into these data. Sometimes an unnecessary test leads to more harm than good.

[GTFan]

Well yeah, but you could also develop cancer that could've been caught in time if you had regular work done. Still not following how this is a bad idea regardless of the possible negatives, because you can always discontinue something that is unnecessary. You can't cure something when it's caught too late.

The possible good of having checks done far outweighs the bad, in other words. But I get it, everyone is entitled to roll the dice when healthy.

[Alan]

Quote:

Originally Posted by GTFan I'm not following how getting routine blood work done is useless regardless of what little else is done. Tons of stuff can be caught that way.

A very good friend, neighbor and colleague of mine literally dropped dead in his kitchen a few days before his retirement from cardiac arrest. He was 60 and otherwise very healthy. The PM showed very low levels of the metals needed for good electrical signals to the heart (Sodium & Magnesium I think).

We continued to be very good friends of his widow and she always blamed herself for not nagging him enough to have annual physicals in case the low metals in the blood work would have indicated a time bomb that could have been diffused with a change in diet, a multi-vitamin or even a banana a week.

Who knows, but I like to have blood tests done each year or 2.

[pb4uski]

I wonder whether standard blood work would have flagged low levels of those metals and hope that his wife is not feeling guilty for no good reason.

[Alan]

Quote:

Originally Posted by pb4uski I wonder whether standard blood work would have flagged low levels of those metals and hope that his wife is not feeling guilty for no good reason.

I really don't know. Looking at the blood tests I had done in February for my routine physical it includes levels of Calcium, Sodium and Potassium.

[Meadbh]

Quote:

Originally Posted by Alan I really don't know. Looking at the blood tests I had done in February for my routine physical it includes levels of Calcium, Sodium and Potassium.

This might make sense if you have hypertension.

Screening strategies for chronic kidney disease in the general population: follow-up of cross sectional health survey | The BMJ

[bingybear]

Before the ACA offered insurance... I had a colonoscopy and they found a polyp which they removed. This was not with an HSA plan. This changed the procedure from well care/routine to diagnostic. I got to pay the agreed upon rates.

There has been some talk in the ACA (govt side) that this was not suppose to happen as somewhere around half have something found.

The other aspect of this is that I've heard that all future colonoscopy my be diagnostic if they ever found something.

[Alan]

Quote:

Originally Posted by Meadbh This might make sense if you have hypertension. Screening strategies for chronic kidney disease in the general population: follow-up of cross sectional health survey | The BMJ

...or over age 55 if I read the conclusion of the above report correctly, so my 60 year old friend might have been wise to have had a blood screening. (gosh, I'm 60 now)

Quote:

Conclusion Screening people with hypertension, diabetes mellitus, or age >55 was the most effective strategy to detect patients with chronic kidney disease, but the risk of end stage renal disease among those detected was low.

[sengsational]

Quote:

Originally Posted by John Galt III ...Maybe the doctor learned his lesson from me a few years ago when I refused to answer any questions he had for me, and stated that I was not answering or asking any questions since I did not want to be charged more. I also stated that I thought it was sleazy to charge more money for actually trying to talk about one's health at a visit one was already paying for.

I also expressed reluctance to talk about anything extra beyond the annual physical, and my doc said "go for it...this will all be preventative no matter what..we'll book another appointment if we need it". I was really pleased by that. Surprised, actually.

[Helen]

Quote:

Originally Posted by sengsational I also expressed reluctance to talk about anything extra beyond the annual physical, and my doc said "go for it...this will all be preventative no matter what..we'll book another appointment if we need it". I was really pleased by that. Surprised, actually.

I think that's the way it should be. Part of a physical should include giving your primary a status on your health and any changes from the prior year.

From what I've seen, I can get a more complete exam for $35 from a local hospital (outside of my health care plan) and not risk any extra charges. I am going to do that next year.

[pb4uski]

Quote:

Originally Posted by Helen I think that's the way it should be. Part of a physical should include giving your primary a status on your health and any changes from the prior year.....

+1 I think the periodic physical should be an open discussion with your doctor and if the discussion leads to tests or services that are outside preventative that is fine as long as you are warned in advance that it will be extra and preferable also what the negotiated rate cost for the extra service is so you can make an informed decision whether or not to proceed.

[travelover]

Quote:

Originally Posted by pb4uski +1 I think the periodic physical should be an open discussion with your doctor and if the discussion leads to tests or services that are outside preventative that is fine as long as you are warned in advance that it will be extra and preferable also what the negotiated rate cost for the extra service is so you can make an informed decision whether or not to proceed.

Agree, but many docs seem to be clueless with regard to 1) what is covered by insurance, and 2) how much anything costs.

[Texas Proud]

Quote:

Originally Posted by sengsational I also expressed reluctance to talk about anything extra beyond the annual physical, and my doc said "go for it...this will all be preventative no matter what..we'll book another appointment if we need it". I was really pleased by that. Surprised, actually.

Another one who agrees with this doc....

I was surprised by my last visit with my doc... I had to change plans and he is not on my new one... he asked if I had a HD plan... yes... so he said, 'if you come here I will only charge you $50 to $70 for a visit and the actual cost to me of any tests'... said to use the insurance for any major issues that might arise... thought that was good of him to do that and I will be going back to him... save my 3 'cheap' visits a year to my primary care doc to something else that happens to me....