Fourth Quarter Check-in: Time to Take Full Advantage of Your Health Insurance Benefits
10/14/2024
TUCSON, AZ (Oct. 14, 2024) – The last three months of the calendar year present a great opportunity maximize your health insurance benefits in order to get the most out of your coverage – especially if you have already met, or are close to meeting, the annual deductible.
Many insurance plans will cover most, if not all, costs for eligible medical procedures and treatments once you meet the deductible and out of pocket maximum, so now is the time to schedule medical procedures – and, ideally, have them taken care of before Dec. 31.
“We encourage everyone to make the best use of all preventive care and medical services available through their health plans,” said Brian Sinotte, Market CEO of Northwest Healthcare. “On Jan. 1, your financial responsibility for deductibles and out of-pocket payments will reset – so it’s important to utilize all of the benefits you’re entitled to before the year ends.”
For example, if you have a $2,000 deductible and a $4,000 out-of-pocket maximum, you are responsible for paying for many medical expenses until they reach the $2,000 threshold. Once they pass this mark, the insurer begins paying a larger portion of the cost of services eligible through in-network providers. When expenses reach the $4,000 out-of-pocket maximum, insurers will pay the total cost for eligible services.
Remember, monthly premium payments do not count towards deductibles, and in most cases, copays do not count either. And, once a new policy year begins, both deductible and out-of-pocket maximum contributions return back to zero.
Another critical aspect of leveraging health insurance benefits is preventive care.
Regardless of whether your health insurance is through an employer, the Marketplace, or Medicare, preventative care is generally covered – including annual wellness appointments and immunizations. Many people skip an annual physical because they ‘feel’ healthy, but these appointments can reveal underlying issues that might not yet show symptoms – when they’re easier to treat.
Key screenings, such as mammograms and colonoscopies, and elective surgeries, such as joint replacements and hysterectomies, may also be less expensive once you've reached your deductible. These services can be harder to schedule during the last quarter of the year, but not impossible – so please contact your healthcare provider as soon as you can.
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