Qustions about insurance company asking my doctor to examine me and the process of being examined by

I'm looking for advice on how to proceed tomorrow.

This afternoon I had a call from my physician’s office to have me come in for a physical exam. I was quite surprised but the receptionist said my insurance company wanted me to have an exam before the first of July, and it was already getting close to the end of May, and I planned to be traveling much of June.

I thought an exam was rather unnecessary, but I agreed to be there tomorrow and was told a female physician assistant would perform the exam. I found it interesting that the receptionist told me specifically that my doctor would not be examining me and she wanted me to know I would be seeing a woman. I have never met this woman, and was told she was new at the medical office, but that’s not my question. I assume she does this regularly. My conversation with the receptionist went as follows:

“Is there anything I need to bring?”

“No, not really, it will only take twenty minutes or so.”

“I don’t think I have met her. Have I?”

“No, she’s new here.”

Now, I don’t mean to complain, but I have gone to this doctor for many years, and although he schedules a physical occasionally, maybe once a year, his physicals are very basic, so I assumed it means she will follow his procedure, and that means I wouldn’t need to lower my shorts.

Frankly, I have been gravitating towards female doctors for the past two or three years because I think they listen better and are a little more thorough than males, but realistically that may be my imagination.

I see a female dermatologist and cardiologist and am very pleased with their thoughtful questions as they both discovered issues that may have been life-saving.

So, here I am, and I don’t know what to expect during my physical. Here are my questions:

• Should I expect to be asked to remove my clothes for the exam?

• If not, should I ask?

• Why is my insurance company requesting this?

• Do they know something I’m unaware?

• If they give me a gown should I remove my underwear?

• Should I ask her about a possible slight rupture or groin pull or should I expect her to find the tender area?

• Should I schedule a separate appointment for her concerns?

• What about slight discomfort in a hip and upper leg when walking?

• Will they do an EKG?

• Should I volunteer that I have lost at least 40 pounds in the past year?

I am looking forward to tomorrow’s physical as I have been having some issues I really don’t want to talk with a man about, but I’m not sure it is appropriate to bring them up with the PA during a physical exam.

As far as why the insurance company is requesting it, there has been a heavy push towards preventative care. Insurance companies are going as far as offering incentives for patients to see doctors or calling up the doctor's office themselves to schedule appointments (when they don't even know how the patients schedule looks).

In my opinion, why make two appointments when you can just mention your problems while you are there. If she thinks you need another appointment for it, she will tell you. Any extreme amounts of weight loss or gain should be mentioned if you have any joint issues. That being said if you had been in when you were heavier they will most likely notice the weight change. I wouldn't worry about it being PA versus a doctor. If it is something they cannot help you with they will tell you.

Hope that helps 😃

You should ask the Insurance Company why a medical is required, but it is a bit late to be asking this question.

You have to be totally honest in answering all questions and you should volunteer your weight loss and other areas which give you concern If you don't then your insurance could be void.

As the examination will only take 20 minutes it is unlikely that an EKG will happen.

They will tell you what to do regarding dress protocol.

But in my experience I would expect you to be asked to drop your shorts.

If you have health issues then schedule another appointment with your Doctor.

Thanks for the responses. I really do appreciate it. I'll post again on the results. I am guessing it will be a simple exam to satisfy some insurance survey or whatever.

You should ask the Insurance Company why a medical is required, but it is a bit late to be asking this question.

Absolutely, this is the correct answer. If you don't know why this exam is being requested, call your insurance company and ask. I'm sure they'll tell you. After all, it is YOUR HEALTH, not theirs -- and you should be the one to make decisions like this.

As to insurance companies now starting to request routine exams like this, I'd agree to a point. In my own experience, it's the employer requesting these routine "wellness" exams -- not the insurance. By making sure that every employee goes through a very basic routine check once a year, it theoretically lowers their benefit plan costs. The idea is to detect, treat and prevent major problems (diabetes, etc) before they get to the point where they cost even more to handle. I've never actually seen a case where it's the insurance company itself that is mandating this. But again, that's just in my own personal experience, yours may be totally different.

As far as what the exam will entail, you can either just wait and see for yourself (the element of the unknown is always fun). Or if you really need to know in advance, you can call the doctor's office. If it's just a routine "wellness" check, then you likely will not remove any clothing at all. If it's a completely physical exam, you should expect to (sooner or later) be completely stripped.

And I personally gravitate toward female physicians as well. That's just my own personal preference.

Good luck, and please let us know how it went when you're done.

The insurance company wants the exam because they don't want to insure someone who will be a liability to them until a lot of premiums have been paid. The exam protects THE INSURANCE COMPANY. They don't give a rat's ass about YOU.

You should answer their specific questions with specific answers and not volunteer anything specific they don't ask about. The insurance company already knows your medical records for all physicians you have seen.

The insurance company wants the exam because they don't want to insure someone who will be a liability to them until a lot of premiums have been paid. The exam protects THE INSURANCE COMPANY. They don't give a rat's ass about YOU.

I totally agree that they don't care about you -- it's just a business (believe me I detest insurance companies). But unless the original poster is in the process of applying for a personal health insurance policy, the insurance company can't legally reject you from coverage. If this is an employer group policy, then you would have automatically been accepted into the group plan when you were first hired (likely during an initial 90-day period when you were allowed to choose the plan you want). And you would have been accepted regardless of any current health conditions that you might have -- at least during the initial hiring process, or during an annual enrollment period.

Thanks for the responses. I really do appreciate it. I'll post again on the results. I am guessing it will be a simple exam to satisfy some insurance survey or whatever.

I think your doctor's office has hired a new physician assistant and are trying to generate patient visits for her. I doubt the insurance company had any role at all but that it was a purely business maneuver by the doctor's practice. The insurance company was mentioned to make you think you had no choice.

. . . .I had a call from my physician’s office to have me come in for a physical exam. I was quite surprised but the receptionist said my insurance company wanted me to have an exam before the first of July. . . .

I got so pre-occupied with why Jimbo cared about all the other stuff I forgot about that.

I never heard of a doctor calling a patient saying the insurance company wanted them to get an exam. It would normally be the other way around.

Ok, here are the facts. This is a new benefit that my insurance offers which provides a doctor PA to go over all medications, inoculations, colonoscopy history, and physical issues that I reported to her. She asked for information on every one of them and later looked at the situation and made recommendations. Later she provided a paper gown and I undressed while she was out of the room. Interestingly enough it was a different type that was even more difficult to figure out. I still have no clue how to use it because there was only one tie.

She did a complete check including ears, eyes, nose, throat, skin all over my body and checked some recent dermatological issues that seem to be resolved. Apparently, I can have this examination one time a year, and I plan to accept. Frankly, the exam was one of the best I have ever had and included a testicular exam.

Thanks again to those of you that responded to my first post on this issue.

I think the old adage "an ounce of prevention is worth a pound of cure" applies here. It is cheaper to help you stay healthy than it is to restore good health after you lose it.