Health Advocate Blog

New year, new deductible

Did you recently renew your health plan or sign up for a new one through your employer? You may already know that you’ll have to pay an annual deductible before the insurance begins to pay for coverage–or that, if you’re continuing with your plan, deductibles reset in January.  This means you may be paying thousands of dollars for care or prescriptions before most insurance coverage starts. This can be a particular hardship if you have a medical condition with frequent treatments or medications. Planning for anticipated expenses is vital.

Here are some suggestions to help with early year expenses.

Start with a review of your coverage and deductible. End-of-year health plan enrollment can feel a bit overwhelming, and now is a good time to refresh yourself on the details so you can plan for expenses. Revisit what’s covered, how much deductible you must satisfy, and what you must pay after satisfying it until you meet your “out-of-pocket maximum” amount for the year.

Check balances on any spending accounts you may have with your plan. If you’ve enrolled in a tax-exempt Health Savings Account (HSA) associated with your plan, that is a good way to put aside money. So is having a Flexible Savings Account (FSA)—the difference is the FSA contributions don’t always roll over at the end of the year. Be sure to check your balances to see if there is leftover money. Additionally, find out if you can make additional FSA contributions during the year if you have a “qualifying event,” like a new baby or marriage.

Shop around!  Prices can vary considerably for care, procedures and prescriptions. The price of an MRI can differ by thousands of dollars depending on whether you get it a hospital or an imaging center, for instance. For minor illnesses, a telemedicine visit or local clinic can be a money-saving option. Your insurance plan may offer an app or online tool to help you comparison-shop.

Make sure all your care providers are in your plan’s network. Costs and deductibles are typically higher if they’re out of network.

Always ask your doctor about less expensive options. This goes for a major procedure you’re facing or for prescriptions.

Check out nonprofit organizations for specific diseases. The Patient Advocate Foundation’s site, for example, helps connect patients with available funds to pay for expenses.

Above all, don’t forgo care because of the cost. Your condition could worsen and the unpaid deductible you’re trying to avoid might still need to be satisfied.