What’s the difference? What’s covered by insurance?

People often have questions about what is and what is not covered during a preventive visit­—sometimes referred to as a wellness visit for preventive healthcare services.

Winona Health follows standard healthcare billing practices and insurance rules for the type of care you receive.

Preventive/Wellness Visit

Preventive/wellness visit includes:

  • Conducting an exam based on your age and gender.
  • Providing advice about staying healthy and healthy living choices.
  • Identifying risk factors.
  • Screening tests based on age, gender or lifestyle.
  • Keeping your immunizations up to date based on your age and gender.

Annual preventive/wellness visits are covered by many health insurance plans POTENTIALLY with no out-of-pocket costs to you.

Problem Visit

Standard office visit for a problem includes:

  • Discussion of any new health problem, illness or injury.
  • Management of chronic, ongoing health problems and/or medications.

Health insurance treats each of these visits as a single office visit with varying coverage. Your insurance provider may pass some or all of the cost on to you.

Combine Your Visits

Save time and money by combining visits.

When time allows, you may decide to combine your preventive/wellness visit with a problem visit. If you’re here for a preventive/wellness visit and you’d like to discuss concerns not covered under preventive services, you have the option to do so. Please be aware that separate charges WILL apply.

Likewise, if you are here to discuss a problem, your provider could offer preventive/wellness visit services to help you avoid having to schedule an additional appointment to receive those services.

Federal law requires us to bill services for preventive care and problem visits separately.

Billing & Insurance Standards

What’s covered by your insurance policy?

Call your insurance representative before your appointment and ask specific questions:

  • Is a preventive/wellness visit covered under my policy?
  • What screenings are covered (ie: labs, imaging)?
  • What vaccines are covered?

We will submit your bill to your insurance. It is likely that you will have some out-of-pocket expense. If you have questions regarding billing for preventive/wellness visit services, please call the Winona Health Business Office financial counselors at 507.457.7632 or see our web page under the Patients/Billing & Insurance tab.

Winona Health Business Office – 507.457.4579 | Financial Counselors – 507.457.7632

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