Blog and News

One of the leading features of the Affordable Care Act is that all American covered under plans managed through the Act will have “free” checkups. But what exactly does this mean and will those checkups be actually free?



A recent study from the University of Pittsburgh School of Medicine estimated that 44.4 million Americans spend about $8 billion on annual checkups. And once the ACA if fully implemented, an estimated 30 million previously uninsured Americans will now be eligible for annual checkups. Even in conservative estimates, that means billions in costs will now be shifted to insurance providers who are all but certain to pass along those costs right back to consumers in the form of higher premiums.

Plus, there are some experts who claim that routine doctor visits will be far from “free” depending on the annual deductible included in one’s plan. And then there are routine co-payments and laboratory blood work fees that vary depending on someone’s individual plan.

Still, the counterpoint to all of this is that routine annual checkups are cost-effective because preventive medicine helps cut down on future health costs.

But most doctors say that not everyone needs a physical every year. And a recent New York Times report finds that “arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.” The Times points to a recent Danish study which found no discernible benefit over time for those who received annual checkups versus those who did not.

So, who should get annual physical exams? Most doctors agree, people over 50, and anyone who has experienced prolonged pain or similar symptoms. But for everyone else, an over-reliance on doctor visits may not amount to much more than needlessly handing over money to insurance companies.

And regardless of whether or not you need that annual checkup, someone is picking up the bill.