Get Informed
Understanding your healthcare coverage and costs can be overwhelming.
Here, you’ll find helpful resources to guide you through topics like prior authorizations, Medicare coverage, what’s included in your well-woman visit, understanding your deductible, and our general price guide. Our goal is to provide clear, accessible information so you can feel confident and prepared for your care.
Our Price Guide
A comprehensive price guide with estimates for common appointment types is available by contacting our Billing Team. For estimates related to problem visits or consultations, please call our office to speak with a team member for a more personalized breakdown.
What to Know About Prior Authorizations
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Your Medicare Coverage: What to Expect
Medicare may not cover all services during your annual visit. If coverage is uncertain, you’ll receive an Advanced Beneficiary Notification (ABN) form explaining your options and potential out-of-pocket costs.
Medicare covers a pelvic and breast exam and a screening pap smear every 24 months, or every 12 months if you meet high-risk criteria. Medicare Part B covers a yearly “wellness” visit, but this is distinct from a traditional physical exam. It focuses on developing a personalized prevention plan, not a physical exam. If a physical exam is performed during the visit, you may be responsible for cost-sharing.
At your annual visit, you may be offered:
- Women’s Wellness Visit – A review of your health history (not covered by Medicare; $60.00).
- Pelvic & Breast Exam – A physical exam without the health review.
- Screening Pap Smear – Based on your age, history, and current guidelines.
Problem-based visits are fully covered by Medicare at any time, but must be scheduled as such.
Medicare Part B covers a yearly “wellness” visit, but this is distinct from a traditional physical exam. It focuses on developing a personalized prevention plan, not a physical exam. If a physical exam is performed during the visit, you may be responsible for cost-sharing.
For more details, visit www.medicare.gov or contact our Billing Team at 207-885-8400 (option 5).
Well-Woman Visits: What’s Covered and What’s Not
Your annual well-woman visit is covered under most insurance plans through the Affordable Care Act (ACA) when provided by an in-network provider – typically at no cost to you.
These preventive visits may include routine exams, recommended screenings (such as Pap tests, breast cancer screening, and STI testing when appropriate), vaccinations, and counseling on topics like contraception, nutrition, and mental health.
If you discuss a new health concern or a change in an existing condition during your visit, that portion of the visit may be considered a separate service and may result in an additional charge.
Coverage varies by plan, so we recommend checking with your insurance provider if you have questions before your appointment.
Visit Coastal Women’s Healthcare
- 71 US Route 1, Scarborough, ME 04074
- (207) 885‑8400
- (207) 885‑8499
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Office Hours:
Mon–Thu 7:45am – 4:30pm
Friday 7:45am - 4:00pm -
Phone Hours:
Mon–Wed 8:15am - 4:15pm
Thursday 9:00am - 4:15pm
Friday 8:15am - 4:00pm
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Office Closures
Check for holiday or weather-related closures
