Is this possible?

[hillview]

I called my ped to make well child visit appts before school. Last year I called too late and ended up with appts in September. I scheduled for August but the receptionist said she didn't think the insurance would pay for it since it was less than 12 months (it is 11 months or maybe 10.75 months). Is that accurate? I have to have DS2's appt before he starts school. I know I need to call my insurance (BCBS) but thought I'd see if anyone has heard of this.

I could go on to say this is insane, I'd get it if I was trying to do it 3 months after the appt but this seems nuts. Also this appt will still be AFTER both kids turn their next year in age.

/hillary

[WatchingThemGrow]

I think that my ins. co. said it was okay if it was within about 6 weeks. My pedi's office said to check with them as well. Definitely check, though.

[Piglet]

Last year when we were in the US, I got the exact same response from my ped. The kids all needed well visits before school started and then I tried to get them all in for their well-visits on schedule and was told that insurance wouldn't cover it since it was less than a year. In our case it was truly dumb since we weren't even living in the US when their previous well visits would have been done and were forced to play catch up for the sake of the school, not for our sake (since I was always following the schedule in Canada). Crazy!!! I hate insurance foibles!

[BabyMine]

My last insurance was like that. They denied a claim becasue it was 6 days before the year was up. I called and had it overrided. The CS rep said that I could go 2 weeks before the year was up but I needed to call them before and after to remind them to override it. This might be the policy of your insurance so you might want to call them. Luckily our current insurance doesn't have that rule.

[Twoboos]

I would say call your insurance to check. On our play you can have the yearly checkup once in a calendar year. So a few weeks before/a few weeks after, no big deal.

[kdeunc]

Our insurance requires that it be 12 months, not a day earlier for both the kids well checks and my annual gyn visit. My December babies now have well child visits in March.

[bnme]

Call and check because every plan is different. One I had didn't matter if it wasn't in the same year another was a year to the day. Also, our school can't force you to get the physical. They have to use last years records and then you update when the time rolls around. But the school nurse was not very nice about it. I guess it is mor efollow-up for her. I have a DS with a January birthday so it is a problem every year. I am sure this varies by state (I am in NY).

[clc053103]

I was given the same exact warning by my ped.....some insurance will deny if not 365 days after last year's appt. However, we have a PPO - they pay for all appts with copay, and do not differentiate between a well visit and sick visit. Therefore, you could literally well visit whenever you want. Definitely worth a phone call- and if you do have to wait, I agree that sucks not to get it done before school starts!

[zoestargrove]

yup! same thing happened to me. It's so stupid

[alien_host]

Ours is the same...12 months between visits, but I'm not sure if there is a grace period...

Our dental insurance is the same every six months, which stinks b/c now I have a Dec/late June appointment and I'd prefer something more in the school year....I used to have insurance that paid for 2 cleanings per year...regardless of when they were, that was easier IMO.

[ourbabygirl]

Yeah, that's how ours has always been for well-baby visits, my annual exam, and even dentist appts. (can't be sooner than like 6 months apart). Insurance is very annoying!

[lowrioh]

I don't know about child well visits and 12 months because our PPO doesn't differentiate between well and sick visits....but when I went in for my annual PAP I was warned by the OBs office that it wasn't 12 months since my last one so I gave my insurance company a call (United-MDIPA) and their policy is once per calendar year.