Read the fine print

Until last week, I supported the Affordable Care Act. In theory, I still do. But after experiencing one of its main provisions first-hand, I realize theory is not good enough.

Last year, I saw a doctor for what most would define as preventative health care. Last week, I received a bill for every little thing I had done, including the office fee itself. Outraged, I initiated negotiations between my insurance company and the hospital billing office — and lost.

It seems that in theory preventative services and office fees for these visits are meant to be covered 100 percent by insurance. This is done in hopes that people will go to the doctor before things fester and become much worse. What Google and the government website neglect to tell people is the minute details that can bump your visit from no cost to full cost.

For a visit to be covered as a preventative service, no testing can be done during the visit. None. The same goes for complaints. A single complaint written down by the doctor makes the visit a medical visit instead of a wellness visit, as representatives explained. A wellness visit is for healthy individuals with no complaints, which seems to defeat the purpose of going to the doctor. If I have no complaints and can’t have any testing done during the visit, why else would I go?

The act was intended to encourage people who might not otherwise seek help and ensure they catch illness before they get worse. But I forgot this isn’t a perfect world, and insurance companies quickly find any loophole they can to extort.

In theory, the Affordable Care Act has more positives than negatives. It requires insurance companies to accept clients with pre-existing conditions, and extends the age for students to be covered by their parents’ insurance. I can only hope the provisions actually function as intended. Unfortunately, this enlightening experience has brought back the cynic I thought was gone.

But I did learn women’s wellness visits are covered, which includes a pap smear. And that’s good because that’s what I was really looking forward to.

Katy Sword can be reached at [email protected]

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