Maximizing Your Health Care Plan Benefits


Most health care plans include a deductible. The deductible is the amount you are obligated to pay before your health insurance begins covering the cost of certain treatments (or tests) either in full or with a co-payment. Health care plans are renewed yearly, typically at the end of the calendar year. That means your deductible will be reset on January 1st, 2016. At the end and at the beginning of each year, you have a unique opportunity that can help bring down your cost of your medical care. The Orthopaedic Specialists team wants to help you maximize your benefits by scheduling treatment when it best suits your needs and goals. Here are some tips to make your health plan work better for you.

If your deductible is paid off or nearly paid off for 2015, now is a great time to schedule treatments or procedures. With the deductible close to or completely settled, your insurance should cover most (or potentially all) of the cost of your medical care. This can significantly lessen your financial burden for surgery or costly diagnostics like an MRI. It’s important to speak with your insurance provider to discuss the specifics of your coverage before proceeding.

If you’re not close to paying off the deductible, you can delay your procedure until the beginning of next year. Although the cost will be primarily your responsibility, you may eliminate a majority if not all of your deductible early in the year. Any further medical needs should then be covered, excepting co-pays or non-covered services. Again, you should review the terms of your plan before making any firm decisions. The Orthopaedic Specialists team has insurance specialists who can assist you with this decision.

Another option is to use your Flexible Spending Account (FSA) if you have one. This money is yours to use for medical needs as you see fit, but the funds disappear at the end of the year. December 31st, 2015 is coming up, so now is the time to schedule your treatment and use that line of revenue before it goes away.

Your health care plan should make the treatment you need more affordable, and we can help. Contact us today for more information or to schedule a consultation with one of our orthopaedic surgeons.