brit_usa2014

Been in Mass for about a year now after moving from a different state and not yet registered for a PCP.. Once you're registered, how much do they charge you (out of pocket) for each visit? Or does it depend on the type of health insurance/state/GP?

Sorry if these seem kind of obvious questions, but still cannot understand how health insurance works here!

Nutmegger

That will depend upon your insurance policy. Read your contract or call their helpline to get an answer.

Bob

Depends on the insurance...usually have a co-pay of $10-50 bucks.

Then you get a possible bill for a whatever the insurance doesn't cover.

Annual physicals usually shouldn't cost you anything, certainly for kids stuff.

SanDiegogirl

Do you have health insurance?

Reading your earlier posts it appears your husband is on an H1B - so should have company health insurance. Ask your HR or read your insurance documents

petitefrancaise

I always asked the receptionists when I booked the appointment if they could take a look at my coverage on their system to see how much my co-pay would be. They take all your details anyway and so far, they've been spot-on.

Pulaski

That's probably just good luck as there is no particular reason for them to know, other than perhaps to look at other patients with similar insurance, and in fact there is no particular reason for them to care. In the past when I have seen a GP, the desk clerk always asked me what my copay is.

In short, your copay is listed in your detailed papers from your insurer, and if you're not sure and want/need to know, then phone your insurer to ask. As per someone else asking recently about registering with a doctor and whether the doctor would get paid, all questions about insurance and payments need to go to the insurer, not the doctor's office.

We were mis-billed a couple of years ago because our doctor dropped off the "in network" list. Although the bill came from our doctor's office, our query was directed to the insurance company. The insurance company quickly identified that the doctor's record had not been updated, and in no time our doctor was back "in network", and a few days later we got a revised bill.

Noorah101

Yep, this has happed a couple of times to us, too.

Rene

penguinsix

It depends on your insurance and what providers are accepting new patients. Our wiki may offer some insight.

Health Insurance : British Expat Wiki

kins

I have a high-deductible insurance policy. Generally a doctor's visit costs me about $85 to $120 depending on how complex it was. That's the rate Anthem has negotiated for my policy - the originally billed amount is often twice that. The annual physical is covered by insurance.

petitefrancaise

I've just come back from a doctor's appointment where I quizzed one of the staff about how much they know about our insurance details.
When they have your insurance details, they are able to log onto a website and get details of co-pays, co-insurance and deductibles as well as the list of codes to use for possible treatment they might do - including how much the insurance will pay for a particular procedure.

I know that dental insurance is opaque and from personal experience, you can only hope to have a vague idea of what they will pay out.

Pulaski

So even they're getting it from your insurance company.

petitefrancaise

Yes.
The woman I was talking to emphasized that they didn't get any details that weren't relevant to their speciality.

MidAtlantic

In my experience doctors and pharmacies have direct links to my insurer and can tell me immediately what a procedure or drug will cost me.

petitefrancaise

It's especially useful in the pharmacy - my local walgreens has a couple of really great pharmacy techs who have helped me no end trying to figure out various problems. Including phoning the insurers on their "actually get a real person" professional number to ask if the generic of a particularly expensive drug would be covered and cheaper, then phoning the dr to get the prescription sent through. That saved me $$ and lots of time.

The local CVS couldn't give a rats- whatsit about anyone and i avoid it like the plague.