CAP Talk

Operations => Aviation & Flying Activities => Topic started by: RNOfficer on July 28, 2016, 04:47:45 AM

Title: Flight physical covered by HMO
Post by: RNOfficer on July 28, 2016, 04:47:45 AM
I was surprised to discover that my HMO (Kaiser-Permentente) considers the flight physical to be just another medical appointment so I only paid my $10 co-payment.

It might be worthwhile for members to check with their health insurance.
Title: Re: Flight physical covered by HMO
Post by: Check Pilot/Tow Pilot on July 28, 2016, 05:15:47 AM
Quote from: RNOfficer on July 28, 2016, 04:47:45 AM
I was surprised to discover that my HMO (Kaiser-Permentente) considers the flight physical to be just another medical appointment so I only paid my $10 co-payment.

It might be worthwhile for members to check with their health insurance.
Cool, I have Kaiser and my physical is coming up. Did you use a third party AME and if so how did you get Kaiser to pay?
Title: Re: Flight physical covered by HMO
Post by: Live2Learn on July 28, 2016, 02:56:45 PM
Quote from: RNOfficer on July 28, 2016, 04:47:45 AM
I was surprised to discover that my HMO (Kaiser-Permentente) considers the flight physical to be just another medical appointment so I only paid my $10 co-payment.

It might be worthwhile for members to check with their health insurance.

Which class?  1st, 2nd, or 3rd??
Title: Re: Flight physical covered by HMO
Post by: RNOfficer on July 29, 2016, 01:32:29 AM
Quote from: Mission/Tow Pilot on July 28, 2016, 05:15:47 AM
Quote from: RNOfficer on July 28, 2016, 04:47:45 AM
I was surprised to discover that my HMO (Kaiser-Permentente) considers the flight physical to be just another medical appointment so I only paid my $10 co-payment.

It might be worthwhile for members to check with their health insurance.
Cool, I have Kaiser and my physical is coming up. Did you use a third party AME and if so how did you get Kaiser to pay?

Unfortunately, you have to use a Kaiser physician who is a AME. This can be a disadvantage. Everyone knows that some AMEs are more lenient than others and if you're marginal in some way, the Kaiser doc may be less sympathetic.

If there's no Kaiser AME in your area, maybe you can get Kaiser to agree to pay for the out-of-plan visit but be prepared to fight for it. Note that even though you agree to arbitration when you sign up for Kaiser, this does not apply to small-claims court suits. So if your plan would cover an AME exam, there's no Kaiser AME, and Kaiser refuses to pay for the out-of-plan visit, you can have the exam at the AME of your choice then  sue in small claims court for the cost.

You'll need a referral from your PCP first.. Note: There are various Kaiser plans; I dunno whether yours covers Class 3 exams like my does.

Good luck.
Title: Re: Flight physical covered by HMO
Post by: RNOfficer on July 29, 2016, 01:33:58 AM
Quote from: Live2Learn on July 28, 2016, 02:56:45 PM
Quote from: RNOfficer on July 28, 2016, 04:47:45 AM
I was surprised to discover that my HMO (Kaiser-Permentente) considers the flight physical to be just another medical appointment so I only paid my $10 co-payment.

It might be worthwhile for members to check with their health insurance.

Which class?  1st, 2nd, or 3rd??

Mine was for a 3rd Class exam. I don't know about the others. And coverage varies among plans.