We understand that medical billing can be confusing, particularly when it comes to how different types of visits are covered by insurance. A common misconception is that a well exam includes evaluation of new concerns or ongoing management of chronic conditions.

Below is a summary of what’s typically included in a well visit, what falls under a sick visit, and when both may be billed. If a sick visit is addressed during a well exam, your insurance may require separate billing, which could result in additional out-of-pocket costs.

Even if your child’s well visit to Potomac Pediatrics is covered, you may still be responsible for part of the cost — including co-pays, co-insurance, or deductibles — depending on your insurance plan.

We hope the information below helps clarify when you might receive a bill and why.