Be th’ insurance company takin’ me doubloons?

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Be off in fer me #ACA Wellness exam (covered 100% No Deductible) Kaiser Permanente sends me a bill fer it. Blimey!

Today is Talk Like a Pirate Day and what’s going on here is pure Hornswaggle. I had the same issue last year with John Muir Health and Blue Shield of California, to be fair. The intent of having Preventative is for catching and treating a health problem before symptoms start. Health insurance plans must cover preventive services without charging you a co-payment or coinsurance. Insurance company actuary’s price for this in their plan pricing.

The Affordable Care Act has been around for three years now, so the excuse that, oops we coded it wrong is kind of a cop out. So I wonder why does this still happen. Are they “double dipping”, collecting the premium for a 100% benefit and billing insureds for these services as well?

I posted this on Linked In and Twitter and this morning Kaiser’s social media team called me. I didn’t have to call them. In the middle of the call I has an epiphany that I shared with the Kaiser representative. It’s 12 or 18 months from now and I’m watching a late movie on the couch when all of a sudden a commercial with a stern looking spokesperson comes on and exhorts, “Have you had your wellness exam with your insurance company and been charged for services that should have been covered at 100%? Be part of a class action lawsuit to collect damages for the time, pain and suffering (have you heard their hold music?) your insurance company has caused you.

This preventative care charge could be the new asbestos! I mean Mesothelioma, who had ever heard of that before the lawyers got involved?

The ACA does mandate coverage for the annual wellness visit, but the blood work (which is the draw and two panels) may or may not be covered, depending on your insurance plan. When you go in for your wellness exam they draw two vials of your blood for testing. You should have the expectation that this testing is part of the wellness exam protocol that’s designed to make sure you’re healthy.

So if you’re an insurance company like Kaiser which has built it’s business model on “Thrive” I would think you would want to motivate and give the incentive to insureds to take care of themselves and catch health issues early when treatment is less costly and the outcomes are better.

No matter how this turns out I’ll still go in every year to see how my body is doing, or more importantly, what changes in my diet or lifestyle I can make that will ensure good health.

For an Old Salt, the preventative exam is the Crows Nest view to longevity. Because Dead Men Tell No Tails!