Survey about your physical (medical exam)

[Coco]

Sorry, but this is a US question. I would be very interested to hear how other countries and insurance systems handle things, though!

OK, you go to your physical, and your doctor orders blood work.

You leave the doctor's office, walk down the hall and get your blood drawn.

Now - are these labs part of your physical, or are they medical procedures outside the physical?

Does your answer depend on whether or not the lab is ordered simply because of the passage of time (i.e., pap smear) vs. being ordered in response to a symptom?

I know we have some medical professionals on the this board, but what I'm really hoping to find out is the average lay person's perception of what is going on during their physical.

[Prancer]

I consider the labs part of the physical.

[Skittl1321]

I have my physical, which has to include the well-woman exam at the same time for my insurance to cover it (if I have it done at a separate time, it is not covered fully). My doctor's office cannot draw blood (they do take the urine sample). The paper work is computered over to LabCorps and I got there in the next week or so.

However, my insurance covers the full cost of the physical (assuming deductible is met, but usually I have 20% copay, not for physical) and the lab work on the blood drawn.

I have blood drawn yearly and have various tests run on them (cholesterol always, iron, other random stuff. That is passage of time stuff. This year there is also a thyroid check and a diabetes check, that's symptom related.) All of this is covered as part of the physical, so I assume it is part of the physical.


What I want to know is why my NP always does the "coordination" stuff at the end of the physical. We always sit down and talk for 20 minutes, then do things like blood pressure, temperature, look at the ears, eyes, nose, throat, listen to heart, lungs, and then I change for my well woman. Then, after that, when I'm naked in a paper gown she has me kick against her hands, stand and balance on one foot, tip toe walk forward back, heel walk, etc. All normal things other doctors have had me do- but seriously lady- can I wear clothes! (Not that anything can be seen, nor would it really matter based on where her hands had just been, but it's odd.)

[numbers123]

Are you asking from the standpoint of what insurance or healthcare costs are covered?

If I have an annual exam that includes pap smear, Lipid Profile, CBC, Glucose, UA, EKG, and mammogram it is usually coded and paid for under that annual preventive exam.

But if during that exam, I say I am having symptoms of say Lupus and would you do the blood tests for that and she orders it, it may not be covered as part of that preventative annual physical.

I would consider it all part of the annual physical, but the insurance provider may not.

[Satellitegirl]

Yes, the blood work is part of the physical. My insurance includes it in the physical. I get once physical a year, free.

[Veronika]

I have a health insurance background, so I'm not really a layperson...but here are my thoughts.

An insurance company would possibly consider the blood draw procedure itself to be part of the physical, but the pathology/labs are considered ancillary services and could be billed separately. I would think since they are all grouped under one provider, they should all be part of the physical. Butt here are a lot of variables in this equation.

I know when my mom gets her yearly colonoscopy, she gets billed for the procedure, facility charge, and interpretation/labs. She has a large deductible on her insurance, and she will sometimes meet it when she gets her colonoscopy.

[MacMadame]

I don't consider it "part" of the physical. For one thing, I get lab work done at times other than my annual physical. So I consider it my annual lab draw and my annual physical and my annual mammogram, etc., etc. I do as much of it on the same day as possible but I need to be referred out for all of it so I consider them separate services.

[Marge_Simpson]

Tip from a medical technologist: if you are having blood drawn, make sure the tubes are labelled with your name before they are drawn. If they are labelled afterwards, make sure this is done in your presence.

[Coco]

Thanks, everyone!

As you might guess, I'm having some issues with my doctor and insurance company. I have a health savings account and very large deductible. I love the HSA, and the deductible is part of that.

My physical is covered 100%, so I was surprised to receive a nearly $1,000 bill after my physical. Apparently, some of the bloodwork my Dr. ordered was not considered part of my physical. It seems that if a test is NOT in response to any specific symptom, it will be part of the physical. But tests that are in response to symptoms discussed in the physical aren't covered.

I get that logic, but I didn't know this before hand. I don't think it is common knowledge, so I don't think I should have been expected to know it. I just feel this should be disclosed before I agree to the bloodwork.

Having the high deductible has really soured me a bit on the medical profession as a consumer. I call around to get prices and it's like running into a huge brick wall. If anyone else ran a business like this, they would fail. I get that a lot of times they don't know what services they will be providing until they get a look at the problem, but they could still publish a range. Sooooooo irritating!