General Discussion
In reply to the discussion: Did you notice you didn't have to pay a copay for your annual exams the last 2 years? [View all]Honeycombe8
(37,648 posts)That is the law.
That is NOT an exam to treat or be examined for some problem.
If you have been charged copays, it is the CARE PROVIDER who is illegally charging you, I believe. They are in essence getting money under the table.
Look at your Statement of Benefits from your ins. co. I'm gonna guess they don't credit you for any copay, because they didn't authorize one. If they did, then it was the INSURANCE COMPANY who illegally got that copay.
Now you know. It is the law that PREVENTIVE CARE well exams do not require copays. You should tell the care provider that, next time they try to charge you.
It must be a main treating physician, like an internal med. dr., a gp, and it must be an exam for wellness (as opposed to checking you out for a complaint). That includes mammograms.
That are exceptions for kinds of ins. that don't fall under the ACA, like federal government plans, military insurance, etc. The ACA doesn't apply to those, I believe.