Copayment or No Copayment?
Even if a physical or preventative test is fully paid by insurance, you may STILL have a copayment/coinsurance/deductible for the visit. SEE EXPLANATION BELOW.
You child’s Well Visit (Annual Physical), which includes a routine physical examination, routine labs, routine vision and/or hearing and routine immunizations normally does NOT require a copayment.
HOWEVER, if you discuss concerns or symptoms for acute or chronic conditions or a problem-oriented condition is discovered during the well check, it is considered “diagnostic” and you will most likely be required to pay a copayment/coinsurance/deductible if applicable.
- An appointment is scheduled for a Well Check (Annual Physical).
- During the physical, you express concern(s) and are treated for an unrelated problem(s): symptoms of acute illness (cold, cough, ear pain rash, etc.), concerns about an uncontrolled chronic condition (ADHD, skin problems, weight issues, etc) or requesting changes to medications.
- In compliance with insurance company billing policies this prompts charges for both categories which requires a copay or coinsurance/deductible, should you have one.
Well Visit Packets PDF