Annual physical and a high deductible plan

[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]

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]

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]

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]

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]

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)

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]

...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]

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]

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]

+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]

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....

 

[FUEGO]

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....

That's about what we pay for most sick visits after insurance. He's probably happy to get $50-70 cash (or CC payment) on the barrelhead and not have to file insurance, fight with them, refile, etc. Just for $50-70.

With our HD plan, they would have to file, wait a month or two, balance bill us at the negotiated rate, not everyone pays on time (though we do), and then wait for the $ to roll in 90-120+ days after the office visit.

 

[clifp]

This:

Annual physical exams may not be necessary after all | Lifestyle from CTV News

I am really curious what the doctors and nurse opinions are on this study.
I switched from standard Kaiser grandfathered plan that was almost $400/month to a HD plan that is $170, but includes nothing, not even a annual physical. Kaiser told me the normal cost for Dr. visit was $125-$150 and the blood work and such I think will run another $100-150. For the 230/month I am saving I figured an annual doctor visit was perfectly reasonable, but do I even need to go?

 

[sengsational]

That article is based on a paper which says "We did not include geriatric trials."

It goes on to say that they found that mortality from cardiovascular issues and cancer were not correlated with an annual physical for the people in the studies, but we don't know what the ages of the participants were, and they don't say in the summary that annual physicals were uniformly not useful across all ages.