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New legislation doesn't cover yearly checkups for state employees under 50

(WCIV)

How often should you go see your doctor when you are not sick? If you look on federal websites like the one for the Centers for Disease Control and Prevention, you should go once a year.

But new legislation just signed into law by Governor McMaster doesn't cover a yearly checkup for state employees under 50-years-old.

Everyone ends up at the doctor's office eventually, but what should you be paying out of pocket?

State employees like teachers, have been waiting to get their wellness visits covered, that's the annual exam for most.

But the way the state health plan is set up, these visits will be less frequent.

“They are doing more than they were before but it’s still not enough,” says Emily Skinner, a literacy professor at the College of Charleston. She teaches teachers how to teach, and is covered by the same state employee plan. Now she pays $300 out of pocket for her yearly exam.

She's concerned about wellness visits under new state health plan, “the wellness is usually the only thing I require of my insurance for my personal insurance. To not cover that seems like a rip off.”

According to the S.C. Public Employee Benefit Authority (PEBA), the new state health plan provision says that if you're between 19 and 39 years old, you get a wellness visit every three years.

If you're between 40 to 49 years old, you get a visit every two years.

Justine Dela Rosa Decastro, MD, a family physician with Seewee Family Medicine, says you should go once a year, "that’s the way I was trained and that’s the way I think it needs to be done, even if everything is going great, it is still good to establish a care with a primary care physician. Let us be your health care quarterback.”

A health care quarterback that evaluates your physical, mental and even spiritual well-being, DeCastro says:

So that when they do get sick with a cough and cold or what not, they are able to come here where we know them as a patient, we known their background, we know their history, family history and we are able to care for them better.

Ironically state teachers just received a one percent salary increase this year as well. “If you do the math, for a starting teacher one percent increase will cover their wellness visit,” says Skinner.

If you are over 50, PEBA says you’re covered for an annual well visit. According to the Centers for Disease Control, chronic diseases like diabetes, cancer and heart disease account for 7 out 10 deaths among Americans each year. Those are the types of diseases that run in families.

DeCastro says that's what doctors are looking for, those kinds of indicators in your annual wellness visit.

We reached out to PEBA to find out how it created these age and frequency requirements for wellness visits. PEBA says it was done by staff members, in collaboration with the agency’s contractors and consultants.

The plan was presented to the State General Assembly and signed into law by Governor McMaster.

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