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Paying for Prevention?


  05:15:04 pm, by MedBen5   , 273 words,  
Categories: Wellness, Discounts, Health Plan Management

Paying for Prevention?

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An article on The Wall Street Journal website offers some cautionary food for thought regarding preventive care. It highlights multiple instances of patients who received such preventive services as colonoscopies and mammograms under the (correct) impression that they should be covered in full under their plans, only to later be billed when their insurers did not consider the treatments preventive. In most cases, the patients were able to eventually remedy the situation, but not without struggling through red tape first.

So what’s happening here? Sometimes, it comes down to miscommunication between patient, physician and insurer. If the doctor’s office is unaware that a health plan covers preventive care at 100%, the patient may still be billed for a copayment or deductible. Or, if medical codes on a claim do not indicate preventive care was provided, the insurer will not treat the claim as such.

While MedBen makes every effort to ensure that providers are informed about which services are treated as preventive care under group plans – and which services are covered in full – discrepencies do sometimes occur. As such, we encourage plan members to specify to their physicians that they are requesting a wellness exam covered under the plan (as opposed to requiring surgical procedures, treatment of existing conditions, or other care not generally classified as preventive).

Preventive care is essential to good health, which is why MedBen Worksite Wellness emphasizes annual checkups as well as early detection testing for cancer and other chronic conditions. To learn more about our wellness program, please contact contact the MedBen Sales and Marketing Department at (888) 627-8683. You can also read about MedBen Worksite Wellness at

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