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FREQUENTLY ASKED QUESTIONS

1. My insurance has a Health Savings Account. How does that work with Tolbert Medicine?

HSA plans typically have no limits for preventive medical services. The $1500 fee is for the medical services of "wellness planning with an annual executive physical, including diagnostics, screenings and counseling.” It is not for a membership to the practice. All other aspects of the practice are noted as benefits. Upon payment of the fee, you’ll receive a receipt stating the medical services to be provided. Some insurance companies will approve payment for services only after the patient has received them.

2. I have a commercial insurance plan (BlueCross/ United/State/Aetna/etc.).
    Will my plan cover any of the $1500 fee?

This fee is for the medical services of “wellness planning/physical/screening diagnostic tests/counseling.” These services are considered to be preventive and most insurance plans don’t cover preventive medical services, although some plans will provide limited coverage. Tolbert Medicine will provide an itemized receipt upon request and with approval, you may be able to recover a portion of the annual fee.

3. Can I file my own claims with my insurance company?

In instances where you select a service that incurs an additional charge above the $1500 fee, you may be able to file a claim for that service. Tolbert Medicine won’t file claims for you but we’ll be pleased to provide assistance if you have questions.

4. Will you be “in-network” and covered by my insurance plan?

Tolbert Medicine has no formal arrangements with any insurance carrier, so we aren’t an “in-network” provider (one of the hallmarks of this practice is that we don’t have relationships with insurance companies, which protects you and Dr. Tolbert from their efforts to limit the care you receive). This means there are no limits to the care Dr. Tolbert can provide for you or coordinate for you, such as prescribing medicines, ordering lab tests and images, and making necessary referrals. The bottom line is that Dr. Tolbert will do what’s best for you, not the insurance company.

5. I have Medicare.  How will this work with Tolbert Medicine?

Medicare will not pay any part of the $1500 fee for the medical services of "Wellness Planning with Annual Executive Physical including diagnostics, screenings, and counseling.” Medicare is empowered to be intrusive and restrictive at will.  To protect her patients and practice, Dr. Tolbert has “opted out” of Medicare, so Tolbert Medicine will neither ask for nor accept any payment from Medicare.

Dr. Tolbert’s decision to do this only helps you as a patient, as “opting-out” in no way restricts her services as a doctor.  She can still order tests, prescribe medicines and make referrals for you. In addition, working with Dr. Tolbert won’t limit your options for working with other doctors.

6. What tests does Tolbert Medicine perform?

Tolbert Medicine performs many typical clinical tests, such as urinalysis, strep throat and flu tests, blood sugar and hemoglobin. We also perform pulmonary function testing, hearing tests and electrocardiograms. We don’t provide
x-rays or diagnostic imaging.

7. Where should I have my blood drawn?

We’ll draw blood in our office as a service to you. These samples are sent to the outside laboratory that your insurance requires on the same day. That laboratory processes your insurance for the blood work, which is standard operating procedure for most doctors’ offices.

8. Will there be any other costs to me in addition to the $1500 fee?

Patients requiring more than eight total in-office visits will be charged a $50 fee for each additional visit. Dr. Tolbert has never had a patient who required more than eight in-office visits during a twelve month period (she sees most patients two to four times a year). Practically speaking, the $1500 should cover your care.

There may be occasions where Dr. Tolbert provides a service, such as giving flu shots or administering other medicines, as a convenience to you. In those situations, Tolbert Medicine may ask you to reimburse the cost associated with that service. There won’t be “up-charges” to you for these services, as Dr. Tolbert’s goal is to make your medical care convenient and efficient.