Health reform question from a reader

My insurance company has paid for physical exams in the past and now they are saying that under the new Health Reform they only have to pay for three tests. Is this so?


Reply to question

I shared the query with the Chief Deputy Commissioner of the NC Dept of Insurance. He responded that there appears to be insufficient information to answer the question. There is a difference between a physical exam and tests. He indicated that the Life & Health Insurance Division can try to look into this for the reader and it may need to be registered as a complaint and possibly go to External Review. For further details, please go to and/or contact me offline. This, of course, assumes that my Chief Deputy didn't misunderstand the question.

Wayne Goodwin
NC Insurance Commissioner

That doesn't make any sense

There isn't anything about paying for three tests in the ACA. But previously there was no requirement to pay for any physicals, so why would the insurer pay for less care now? Sounds like the usual case of blaming health reform when you want to do something shady.

Adam's reply leads to a broader point

It is extremely frustrating as Insurance Commissioner to learn that an insurance company will assign blame for its own decisions to unrelated matters, whether a federal or state law or merely saying "it's because of the Commissioner." Countless times out-of-state insurance companies will tell agents and consumers half-truths or whole lies, and we have to straighten them out and help the consumer get to the bottom of what's really going on.

@Adam: I presume the caption on your reply pertains to the original question and not to my reply immediately preceding yours? :)