Prime Health Network

Tomorrow's Medicine Today

I'm Scheduled for a Physical, Do I have a Co-Pay?

As a result of recent health care reform legislation, most health insurance plans allow you to receive certain eligible preventive care services without copayments or other cost sharing when these services are provided by an in-network provider. This means that certain eligible preventive services, including screenings, checkups and counseling, are covered with no out-of-pocket cost if you

• See an in network health care professional and
• Receive only preventive care services during your visit.

However...... You are responsible for a co-payment, if your doctor provides non-preventive care services during the course of a visit (even a visit scheduled primarily for preventive care reasons), including

• Treatment and/or counseling for a previously diagnosed chronic condition, such as high blood pressure or chronic obstructive pulmonary disease (COPD)
• Treatment and/or counseling for a newly diagnosed condition, such as an ear infection.

Your doctor acts in the best interest of your health and well-being. If you have questions about the services you receive during a visit, please talk to your doctor or call the member services number on your health plan's identification card