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11 November 2008

Is this strange? My health insurance is changing how visits to the gyn are billed for 2009. Something seems... wrong. [More:]I now have one copay for an office visit, and a second copay if I get a pap smear. Isn't that like saying you have one copay to see the dentist and a second if they use toothpaste on you? I mean, why else do most women go to annual gyn appointments if not for a pap smear?
Now I have to pay $50 for my annual appointment, which is just insane to me. I paid less at planned parenthood back when I had no insurance.
wow. I haven't paid less than $50 for an annual at PP since about 1992, and I've basically never had insurance. Where do you live?

/redstater
posted by lonefrontranger 11 November | 14:27
I was just registering for my new health insurance for 2009 and I noticed a similar thing. Though the people I get insurance through change companies every year and crank up the price and reduce benefits.

but i just discovered i have been paying for dental insurance all year. you think i would have realized that before now.
posted by stynxno 11 November | 14:35
It sounds like a lab fee. Like any time something that came from you is sent to another facility to be evaluated, the second facility gets a co-pay. I would advise you to look into this. If this is correct, you could look for a new provider in network that still has their lab in-house. Although you'd have to consider your familiarity with your doctor and practice, and if you think an off site lab would likely increase or decrease the possibility of error. Talk to your HR peeps and your doctor, too. Don't sign on without understanding what's going on. What a flipping headache. And I take it you mean the two co-pays are $25 each and add up to $50? A $50 co-pay seems way high to visit the gyn, esp. if it's higher than a general physician. I don't think they are supposed to do that. Or maybe they want a g.p. to do the pap for max cost efficiency? Craziness.
posted by rainbaby 11 November | 14:39
Where do you live?
Buffalo. Number two poorest city in the US (in your face, Detroit!)
I was paying $40 for my exam at PP maybe three and a half, four years ago. That was the last time I was without insurance.

It just seems shady, and I really wonder if there are people who won't get a pap smear now since they don't have the spare cash or can't justify it.

It sounds like a lab fee.
That was my thought, but my doc DOES have an in-house lab (they're affiliated with a med school), and the insurance told me that it would still apply. Yep, $25 co-pay, one for the visit, a second for the pap.
posted by kellydamnit 11 November | 14:43
How old are you kellydamnit? Annual paps are recommended only if you're under 30 (due to the possibility of HPV) or have a history of questionable results. Over 30 and with a history of negative results every 2-3 years.
posted by goo 11 November | 14:46
I'm 29, but I've had some come back with funky results in the past (thankfully turned out OK ultimately), and I never got the vaccine since I was too old by the time it hit the US market. So I suspect I'll be getting them regularly for a while. That and, to be completely honest, if anything I'm in a higher risk group now than I was in my mid-20s since I was married back then. I think the "unnecessary after 30" guideline may be based on the idea than you'll be settled down and monogamous by that age, which really isn't the case for a lot of women today.
posted by kellydamnit 11 November | 14:57
The idea of an annual smear test is something that always surprises me because under the NHS it's meant to be 3-yearly up to the age of 49, 5-yearly between the ages of 50 and 64 and after that, it's not generally available to women in the UK.

I say 'meant to be' because I should have had one in the last five years, but haven't received a reminder from my doctor. I think I'll prompt them, because I'm 50 next year and then, knowing the NHS, they'll leave it another five years to contact me.
posted by essexjan 11 November | 15:05
Interesting! I think it might be a difference between a socialised medical system and one in which you're expected to pay - the guidelines where I've lived have changed only quite recently to recommend annual paps for those under 30 due to HPV, not the other way around. I've had them three-yearly in Australia and here in the UK (I'm 31 and far removed from a nun. A history of questionable results of course justifies annual tests, though, and it sucks that your insurance company chooses to fleece you this way.
posted by goo 11 November | 15:18
I read "gyn" as "gym". Yep, I'll just keep on browsing past.
posted by Eideteker 11 November | 15:18
I mean, why else do most women go to annual gyn appointments if not for a pap smear?

Some women use their ob/gyn as their primary care physician, and so would commonly be there for nonjunkular reasons.
posted by ROU Xenophobe 11 November | 15:29
I think that's ridiculous, kellydammit - I'm lucky that my insurance is willing to consider my gyn visit as my annual "wellness" doctor visit, for which there is no copay at all!
posted by misskaz 11 November | 16:16
My insurance considers it a 'wellness' visit, even though my doc isn't in-network or whatever. (I'm not sure if that's the correct term, but he's not on the spreadsheet they post.)

I will say my doc is totes awesome because when I went in with my scary results from PP, he told the secretary to charge it as a "consultation" and not a real visit so I didn't have to pay anything. (I did have to pay the $15 for the second blood test, but I expected that.)
posted by sperose 11 November | 16:56
I have blue cross, we don't have free wellness visits, or free anything else. I really don't care for my insurance at all, I have higher copays and less covered stuff than just about everyone I know. I've had to fight with them about all sorts of things, up to and including them demanding proof of allergic reaction to a med in the last 12 months before they would cover the alternative med. My doc nearly had a heart attack over that- they were asking me to take something knowing it could kill me since the proof it could kill me was two years too old for them.
posted by kellydamnit 11 November | 17:06
I'm not a fan of Blue Cross either. When my mom was diagnosed with a rare disease that affects 2 people in a million -- which, understandably, most doctors have no idea how to treat -- Blue Cross wouldn't pay for her to go to the one clinic in the country that had had success in treating the illness. The reason was that she was in Texas, the clinic was in Colorado, and it was therefore out-of-network. They wanted her to go to a clinic in South Texas instead.

The kicker is that the Texas clinic was further away than the Colorado clinic. Because, you know, Texas is big like that.

Those fuckers pissed me off.
posted by mudpuppie 11 November | 17:14
I'm supposed to have a physical every year and that includes a pap smear. I wonder if that's due to Canadian health care or because I'm diabetic. Maybe both?
posted by deborah 11 November | 22:30
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