Most insurance companies cover one wellness exam per year at no cost to the patient including certain tests to detect disease in early stages or to prevent disease.
Unfortunately, most insurance companies will not cover services unrelated to the physical and can choose to not cover the full cost of the office visit for separate health concerns discussed during an exam such as: addressing new or ongoing health problems (e.g. blood pressure, rash, back pain, UTI, etc), in-office procedures (wart destruction, ear wax removal,etc), laboratory tests for illness/injury or chronic conditions
Some examples of services or discussions that may not be covered in a physical examination: non scheduled but necessary immunizations (TB tests for work, etc), pathology or Pap tests not considered routine by your insurance, tests that are not normally needed due to a patient’s age or health risk. Your doctor may recommend routine laboratory tests for health screening (like cholesterol, thyroid, complete blood count). However your insurance plan may not cover these tests or may consider them as part of your deductible, and you may be billed for them.
Each insurance company decides what will be paid on a case-by-case basis, and decisions made cannot be predetermined by Thrive Medical Clinic. If you have questions about what is covered under your health insurance plan for routine physicals or wellness exams, please contact your insurance company or your Human Resources Department.
Any charges not considered as part of a routine physical or wellness exam will be billed separately and any items or services not covered will be billed to patient.
Thrive Medical Clinic apologizes for this inconvenience and appreciates your understanding that we must follow the insurance company billing guidelines in order to submit claims on behalf of our patients.