"Physicals" or Comprehensive Medical Evaluations (CMEs) as we prefer to call them, are recommended annually, but not all insurances allow this. CME's can be very challenging when dealing with individual insurance companies and multiple plans for each one. It is not always clear what they will pay for. Not all insurance providers cover a routine "physical". Some pay for fairly complete blood work with a physical, some do not.
We strive to obtain details of your routine coverage prior to your visit, but it is always helpful if you understand what your benefits are as well. It may be helpful for you to bring your benefits booklet with you when you come in. If your insurance company does not pay for "physicals", we will perform the necessary evaluations as defined by your benefit plan.
Notes on a Few Popular Plans:
Healthkeepers - Women with this plan need to choose whether they want their Primary Care Physician or their Gynecologist, but not both, to perform the annual evaluation.
Medicare - Medicare does not cover annual physicals. Usually, Medicare patients rely on their secondary coverage to pay for physicals. If the patient has any chronic medical conditions, often we can order lab work to monitor these conditions at the same time as any covered routine blood work.
To help accomplish the most thorough evaluation at the patient's appointment, it may be helpful for the patient to arrive in the fasting state. If the patient is fasting, we can order the necessary blood work during the appointment and the blood can be drawn while the patient is in the office. Fasting means that the patient cannot have any food or drink for at least 12 hours prior to the appointment with the exceptions of water, black coffee, plain, unsweetened tea or diet soda. It is permissible to use artificial sweeteners in the coffee or tea, but absolutley no milk or cream.
If fasting is not possible or your appointment is late in the day, you can always have your bloodwork done at a later date, unless your plan states that it must be done the same day as your visit. If you see the physician for a visit prior to your physical appointment, it is helpful if you ask the doctor or nurse practitioner to order the necessary lab work so that you can have it drawn prior to your physical. This makes it possible for the physician to review your results and share them with you at your physical appointment.
If you do not have insurance to cover routime blood work, Oyster Point Family Practice offers "self-pay" blood work at greatly discounted prices from the normal cost to have them done at another lab or hospital. We offer what is called an "Exec 1" which includes a Complete Blood Count, Comprehensive Metabolic Panel including electrolytes, glucose, liver and kidney enzymes and blood proteins, a Lipid Panel including total cholesterol, LDL, HDL and triglycerides, and a Thyroid Stimulating Hormone (TSH). This profile retails for over $300, but we provide it for $70.
We also offer the "Male Exec" profile which includes all of the above tests and a PSA (Prostate Specific Antigen) assay for only $85. In order for us to track these charges and draw your blood, these tests must be paid for at the time of the blood draw.
The general policy at Oyster Point Family Practice is that we do not call our patients if the results are normal, but we will contact you if the results are abnormal. This policy applies to lab, PAPs and x-ray results. If you want to know your results - normal or abnormal- please call our office and speak with a nurse.