Understanding the Difference

Well-Woman Exams vs. Problem Visits
Understanding the Difference
What is a Well-Woman Exam? Your yearly preventive check-up is focused on keeping
you healthy which includes and is usually covered at no cost by insurance once a year.

• Review of health history
• Vital signs (weight, blood pressure, etc.)
• Breast and pelvic exam (if needed)
• Pap smear (if needed)
• Birth control
• Lifestyle counseling

What’s Not Included in a Well-Woman Exam? A Well-Woman Exam is for
prevention only. If you have a specific concern, that is a Problem Visit. Examples include but
are not limited to:

• Vaginal discharge
• Infection, or itching
• Irregular or painful periods
• Breast pain or lump
• Pelvic or abdominal pain
• Urinary symptoms (UTI)
• Hormone discussions or infertility concerns

Why It Matters!

Insurance companies view these as two separate types of visits:
Well-Woman Exam → Preventive, usually no cost
Problem Visit → Diagnosis/treatment, may involve copay or deductible

If both are done the same day, insurance will be billed for both visits.