Dear Medicare/Medicare Advantage Patient:
Thank you for trusting us with your healthcare needs. Please carefully review the information below as it pertains to how your Preventative Care Services, provided by our office, will be billed.
The Women’s Clinic continues to recommend yearly preventative exams. At this preventative visit (annual exam), several services are performed, which include, but not limited to, review of medical history, thorough physical exam (vital signs, examination of your heart, lungs, thyroid, breast, abdominal and pelvic exam), counseling (such as advice on nutrition, smoking, and exercise), and recommended testing. Medicare does not cover annual preventative exams. Medicare will cover a portion of the visit every other year. The remaining portion will be patient responsibility (out of pocket expense).
Every patient scheduled for their annual exam will receive the full preventative exam. We must comply with the billing guidelines established by Medicare which will result in a cost to you between $242.00 and $292.00 if you are an established patient over the age of 65 (prices are adjusted based on age and new vs established patient status). If you are seeing your provider for preventive services as well as on-going health problems this portion of the visit will be billed separately.
Please note that this does not include the “Welcome to Medicare Visit” and the “Annual Wellness Visit” which Medicare covers for beneficiaries. These visits do not consist of a physical examination and are not done at the Women’s Clinic, but typically by a primary care provider. Please review your insurance documentation for more information.
We cannot do anything to find a way for Medicare to “cover” annual preventative exams. Please note that we are bound by federal law to follow these guidelines and cannot make alternative arrangements with Medicare.
As a courtesy, we bill Medicare for these services on your behalf. If Medicare will not cover these services based on frequency, or other requirements, it is at this time that your secondary insurance, if you have it, will be billed. Please note, your secondary insurance may or may not cover these services as well. Please contact them directly for coverage questions.
If you have any additional questions, please reach out to our Business Department at 402-434-3378.
We thank you for allowing us to provide your care and we look forward to seeing you soon for your appointment.
Women’s Clinic of Lincoln, P.C.