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Comment by prepend | Hacker News Reader

This is a mandatory wellness check that is required for all insurance in the US since ACA came out in 2010 or so, right?

I don’t pay anything out of pocket for my annual physical and I have really bad insurance.

I think this is one of those prices that no one pays as insurance covers it, or you don’t have insurance and won’t be getting any wellness exams paying out of pocket.

I wonder if it’s this level just as a negotiating tactic with insurance. I didn’t look at my explanation of benefits, but I don’t expect my insurance paid anywhere near this much.

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Mandatory? Unless I'm seriously out of the loop, I don't think there are mandatory annual wellness checks in the US?

mandatory that you are offered one by your insurer, not mandatory that you show up to one

PPACA mandates it as a minimum essential coverage benefit, i.e. you don't pay extra for it. Included benefit as part of the plan.

Ah. Mandatory for the insurer to offer, not for the patient to do.

> I think this is one of those prices that no one pays as insurance covers it

Baffling. You obviously pay for it. It’s priced into the cost of your insurance.

Not exactly. Insurance typically negotiates paying a small fraction of the price that cash customers pay.

Medicare has long had a law effectively saying "you must offer Medicare the cheapest price you offer anyone". I wonder how much of an impact it would have on the affordability of care if there were a law saying "you must offer cash customers the cheapest price you offer anyone"?

The insurance company pays, but what they pay is not this price. US medical care is littered with dummy sticker prices that exist to give insurance company negotiators something to do besides negotiate good rates. https://www.propublica.org/article/why-your-health-insurer-d...

Not that straightforward for many. My employer pays for 80% of my insurance premiums, and then the insurer (or my employer) gives me a $200 credit (equivalent to paying me) for going to an annual wellness visit.

Of course, in totality, everyone’s total premiums are paying for the visits, but on an individual basis, those getting the visit and receiving a credit are getting subsidized by those not receiving a credit.

You don’t pay this amount. Healthcare has a tendency to show a high price, then charge a much lower price to insurers. So no one is really paying this price.

So it’s like a Persian rug store where every rug has a $9000 price tag and then every customer pays $3000.

"This is a mandatory wellness check that is required for all insurance in the US" sounds like you're saying paying for this is required to _get_ insurance - but I think you intend to mean that it's required that any insurance plan cover one check annually (which is sort of the opposite meaning)?

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