Under the Affordable Care Act, preventive care includes screenings for high blood pressure and high cholesterol counts, evaluations for several cancers and diabetes, and vaccinations. The patient is allowed, in most cases, one checkup per year.
But "wellness" care on potential new health issues is viewed as "evaluation and monitoring," and leads to patients having to fork out for the "free" annual physical.
"Patients are scheduling physicals because physicals are free," Randy Wexler, a family physician in Columbus, Ohio, told the Journal. "But they come in and say, 'I've been having headaches. My back has been bothering me, and I'm depressed.' That's not part of a physical. That will trigger a copay."
Wexler says they are not happy about the charges. "They'll say, 'I have diabetes and hypertension and heart disease and seeing you is preventing them from getting worse, so that should be fully covered,'" he said. "But under that theory, everything would be free with no copay."
Doctors told the Journal that seniors have started canceling their annual wellness visits under their Medicare plans when they learn that if they mention a current health issue during the checkup they will likely be charged a co-pay.