We have had many Medicare Advantage plans deny the annual gynecological exam as "benefit max reached" "you cannot bill the patient". Aetna Medicare allows a gynecological exam once every 24 months, if the patient comes in early the insurance "normally" denies the claim and makes it patient responsibility. What has changed? We now have the insurance not paying and the patient not being responsible to pay. The doctors should not have to provide services for free!! Has anyone else had this issue? Any advice is greatly appreciated!!!