Deductibles. It’s hard to get away from them: almost every insurance plan has one (in fact, only about 7% don’t). They can be low, or they can be high, depending on your plan, but in most cases they are a significant amount. According to the International Foundation of Employee Benefits Plans, the average family deductible for people enrolled in employer-sponsored plans is close to $2,000. And that’s only the average – 23% have deductibles of $5,000 or more.
Your deductible resets every year; some years you may not reach it at all, and others you might end up seeking more medical care and reaching it well before the end of the year. If this happens, look at it as an opportunity: you can receive all kinds of covered services and your insurance company will pick up the tab. Don’t miss your chance! We’ve got 7 great ways to use your insurance if you meet your deductible before the end of the year.
Before we get down to it, let’s take a quick look at deductibles. Your deductible is the amount of money you have to pay for medical services before your insurance company will even begin to pay their share. For example, if your plan has a deductible of $1,000, you’ll have to pay $1,000 on healthcare costs out-of-pocket, and then your insurance company will cover most of your bills. You will still have to pay your copays and, in most cases, coinsurance, which usually means that your insurance pays 80% of a bill and you pay the remaining 20%.
The exception to all of this is some preventive care services, which are covered in full. You might also meet your out-of-pocket maximum, which is the absolute most you have to spend on medical bills in a given year – once you hit that, your insurance company will cover all of your costs.
Here’s an example of how it all works:
- You have a procedure done on your knee, and the bill is $4,000. If you have that $1,000 deductible, then you’re completely on the hook for the first $1,000 of the bill, leaving $3,000.
- Your plan has 80/20 coinsurance, meaning that your insurance pays 80% of costs after you’ve met your deductible, and you pay the remaining 20%. In this case, your insurance would pay 80% of $3,000 ($2,400) and you would pay the remaining 20% ($600).
- So far, you’ve paid $1,600 out-of-pocket. If you have an out-of-pocket maximum of $5,000 for the year, you’d have to spend $3,400 more in order to hit your maximum – your insurance company would then cover all of the rest of your bills in full.
In the above situation, you’d have more than met your deductible. So what now? It’s time to prioritize some of that medical care you’ve been putting off! But first, remember to always check with your insurance company to make sure that a service is covered. Just because you’ve met your deductible, doesn’t mean that your insurance will start covering things it didn’t cover before.
Here are some ideas of services to schedule before your deductible resets in January:
1. Physical Therapy
Physical therapy can be very expensive, so many people just ignore those aches and pains, or they dismiss their problems, thinking that PT is just for athletes or those with major injuries. But if you’ve met your deductible, why not get that nagging knee pain checked, that stiff shoulder worked on, or that carpal tunnel syndrome diagnosed once and for all? PT can also help with strength, motor skills, and balance and coordination issues. Check with your insurance company to make sure you’re covered, and then get moving!
If you’ve been avoiding a trip to the dermatologist, now’s the time. You should always get any concerning moles or lesions checked immediately, but if you haven’t had a routine skin cancer check, then take advantage of your post-deductible status and get one done. You can also take care of some of those other little skin issues that you can live with and that you haven’t wanted to “waste” your money, like warts, eczema, or skin tags.
If you get on-going injections like those for osteoporosis or birth control, or others like testosterone or vitamin B12, and you’re billed for a nurse visit each time, try and schedule any remaining ones before your deductible resets.
4. Sleep Study
Are you tired all the time? Being excessively fatigued might not be just a fact of your everyday, hectic life – you could have a condition like sleep apnea or narcolepsy. Chronic tiredness can really impact your life, and obstructive sleep apnea can even lead to much more serious issues, like heart problems or stroke. If you’re concerned about your levels of fatigue, ask your doctor about getting a referral for a sleep study. Doctors will monitor your brain and body as you sleep, and you’ll know once and for all what’s disrupting your time in dreamland.
5. Prescription Refills
You don’t have to be completely out of your medications to get a refill, so check all of your prescriptions to see what you might need in the future. You can also ask your doctor if you can stock up – you might be able to get a 90-day supply on some drugs, meaning you can save some serious money if you’re post-deductible.
6. Elective Orthopedic Surgery
Bunions, hammertoes, frozen shoulders, torn meniscuses…there’s a lot that can go wrong with the human body. There’s also a lot of stuff that we’re willing to ignore because of cost. But if you’ve met your deductible, you might as well have that minor surgery that you’ve been putting off – it could end up significantly improving your quality of life!
7. Bone Density Test
Anyone can develop osteoporosis, which is characterized by weak, fragile bones, but it is especially common in older women. Speak to your doctor and get yourself screened with a bone density scan, or DEXA. Osteoporosis is treatable, so this one painless test can help save you from a hip fracture in the future.
Healthcare isn’t cheap. It’s easy to put the little things (and sometimes the not-so-little things) off, and to tell yourself that you can live with them, or that you’ll take care of them later. But if you’ve already spent all that money meeting your deductible, then what better time is there than to take care of those nagging issues? As Open Enrollment approaches (November 1- December 15), it’s a great time to evaluate your plan – is your deductible too high? Or is your premium too high? Get in touch with Best Insurance Group, and we’ll help you find a plan that fits you perfectly. Now go and make those appointments!