Maximizing Your Health Insurance Benefits Before The End Of The Year


Just like that, another year is coming to an end. Before you settle down for the holidays, think about that end of year to-do list. Are doctor’s appointments on that list? Should they be? They should, if you are like many of us and like to save money. If you have met, or almost met, your deductible then now is the time to complete tests, screenings or procedures before the year ends.

Here is how it works: If you have commercial insurance, your policy probably runs through the calendar year which will be ending soon. Most commercial insurance policies have a deductible, co-insurance and maximum out-of-pocket expenses. Your deductible is the amount you must pay before the insurance company begins to contribute. Once you reach your deductible, your policy may move you into a co-insurance percentage. You pay a percentage of any procedure, this amount goes towards your maximum out-of-pocket until you have met that amount. Once the maximum out-of-pocket expenses are met, most insurance companies cover 100%.

What does your insurance look like right now? Have you met your deductible? Out-of-pocket? If you have, then now would be the time to take advantage of those savings. If you are like many of us that needs a deadline to get things done, there is a big one just around the corner. You have until December 31, 2022, to make maximum usage of your insurance. This means you must have procedures completed by then.

Here are a few tips to help you get the most out of your health plan:

ü  If you are considering an elective procedure/surgery, talk to your doctor about the surgery or procedure and obtain the procedure codes. Then call your health insurance provider and ask if you have met your deductible or if you are close to meeting it. Using the procedure codes from your doctor, request an estimate of other associated costs, such as diagnostic tests, reading fees, pathology fees, etc. so you can prioritize your out-of-pocket spending or know if all fees are covered by your insurance.

ü  If you have a Flexible Spending Account (FSA) through your employer, call the customer service number on the back of your card or log into your account to check your balance. FSA funds do not roll over into the following year, so plan to use your FSA money first.

ü  Consider carefully before using Health Account Savings (HSA). HSA contributions do not expire like FSA contributions. You can accumulate HSA funds and save them for a future elective procedure, so use your HSA after you have depleted your FSA.

ü  Set aside a few hours to call your doctor, insurance provider and FSA or HSA account provider. These calls will not take as long as you might think, and they could save you thousands of dollars.

Many plans pay for certain tests and preventative procedures with no cost to you. Schedule these before time runs out. Mammograms, routine exams, immunizations like the flu shot, and other preventative visits are among those to schedule now. Check your insurance information and see what you can still take advantage of without any out-of-pocket fees. It pays to check it out and make a few appointments.

If you would like to talk to one of our financial navigators about your insurance benefits, please call the Hospital at 660-465-8511 and ask for Denise or Michael.

Please choose Scotland County Hospital & Clinics in Memphis for your healthcare needs. We would be honored to care for you and your family.

Here's how it works. After you have met your deductible, your health plan will pay all or a portion of covered services for the rest of the year, depending on the terms of your individual plan. But — if you wait until January 1, 2023, when your deductible resets, you’ll be paying much more for the same procedure, since you’ll have to first pay out-of-pocket to meet your deductible. Out-of-pocket costs for certain procedures can be reduced or eliminated once you have met your deductible and/or your out-of-pocket maximum. On January 1, 2023, everything will reset and begin again.

Here's a broad list of things for you to consider using your health insurance for, after your deductible and/or your out-of-pocket maximum is met.

  • A Colonoscopy
  • An Endoscopy
  • Lab work
  • Diagnostic testing such as mammogram or chest x-ray
  • A dietary nutrition consult with our Registered Dietitian Nutritionist
  • Non emergent surgical procedures like a hernia repair, carpal tunnel repair, gallbladder, or a joint injection for pain
  • Make an appointment with a specialist if your primary care provider has suggested a referral for a nagging condition. We offer cardiology, podiatry, oncology, orthopedic, urology, rheumatology and wound care.
  • Make a clinic appointment with one of our surgeons to deal with a benign skin issue such as a pesky skin tag, a mole, or a discolored skin spot that has changed shape or size recently
  • And finally, come and see one of our physical or occupational therapists for tendonitis or an old sports injury in our Therapy Services Department.

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