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| Save Money on Health Insurance -- Read Your Policy |
You probably know that the codes on
your medical records give a diagnosis of your condition as well as the purpose
for any tests. The ICD is the International Classification of Diseases and the
HCPCS is the Healthcare Common Procedure Coding System. You can read more about
coding on the National Institutes of Health website.
My health insurance covers 80 percent
of preventive care lab work without applying the deductible, but doesn't cover
diagnostic lab work until the deductible is met. My doctor coded the lab work as
diagnostic, and I came out with a $325 charge because I hadn't met the
deductible for the year ($1,000 in personal expenses).
If the lab had been coded as
preventive, I would have paid 20 percent, or $65 instead of
$325.
If I had known this from the outset,
I could have mentioned to my doctor that this was a well visit and that the
blood work was not diagnostic. Doctors usually think all blood work is
diagnostic, since they use it to diagnose your medical condition. However, if
you get bloodwork before you go to the doctor, he isn't diagnosing anything --
it's a checkup.
Insurance is ever evolving, and some
big changes are ahead of us. However, this is one change that has already taken
place. A few years back, if medical care was preventive, it wasn't likely to be
covered by your insurance. Now, preventive care is usually covered by insurance.
The Affordable Care Act requires health plans to cover specific injections and
screening tests without consideration of your deductible. You don't pay a
copayment or coinsurance for covered preventive services. A list of the covered
services for adults are shown on the healthcare.gov website.
Specific preventive services are free
for women and children as well, as shown on the link on that page.
Lesson learned. If you go to the
doctor for a checkup or well visit, tell the doctor you are there for a well
visit for preventive care. The coding can matter to your financial
health.
