Flu shot covered, office visit co-pay still charged?

I took my kids to the doctor’s office for their flu shots.  They told me that the flu shots were covered because of Obamacare, but I still owed the $25 co-pay.  Is that allowed?

Feeling Gipped

Dear Feeling Gipped,

It is allowed, however if the only purpose of the visit was the flu shot, the doctor’s office could have skipped billing the visit (and only billed for the flu shot).  In fact, your plan may refuse to pay a visit fee if the only activity was the shot.  If so, the doctor’s office will have to refund your co-pay.

The Obamacare preventive services that have no co-pay are specific tests and treatments.  It does not include, strangely enough, well child visits themselves.  Your plan might have incentives and waived co-pays for well child visits, and preventive services not on the Obamacare list.

In your case, you would have saved money by taking your children to a pharmacy that offers flu shots or a flu shot clinic.  In many states, pharmacies are licensed to give shots; they can very easily send the record to your doctor’s office.

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.