Tips to Maximize Your Health Insurance Benefits

It’s fall, and more importantly, it’s the mark of the last few months of the year for you to use your health insurance benefits before everything resets on January 1.

With October here, now is the right now time to strategically schedule medical procedures, use your remaining flexible spending account (FSA) funds, and take advantage of preventive care before deductibles and other benefits reset in the new year.

Planning Medical Procedures Strategically

Now is the time to schedule final medical procedures or appointments. How to do it depends on how much of your deductible and out-of-pocket maximum you have already paid.

If you have already met your deductible:

If you have already paid your deductible, or reached your plan’s out-of-pocket maximum, you have a bit more to work with.

Tip #1 – Get any covered services you need between now and December 31. Why? In this situation, it’s likely your insurance will cover a much higher percentage of costs for the rest of the year, which means we have two tips for you.

Tip #2 –  Schedule higher-cost elective procedures ASAP. If your deductible is met, now is the perfect time to get non-emergency procedures done. This includes things like cataract surgery or hernia repairs. Why? Because if you get them done now before your plan benefits reset, you could pay a lot less out of pocket.

If you have not met your deductible:

If you haven’t met your deductible, it’s not a good idea to invest in any big non-emergent procedures. Instead, consider postponing non-emergency procedures until the start of the next year so you can then put the full cost of them toward your new deductible.

Most insurance plans cover preventive services completely with no out-of-pocket cost. This means you can take advantage of these free benefits any time of year, and it makes them a smart choice if you haven’t met your deductible yet.

Preventive and routine care services to schedule (if you haven’t yet):

1.  Annual physical with your primary care doctor

2. Complete any necessary screenings such as a mammogram, and colonoscopy.

3. Schedule mental health counseling or therapy sessions if covered by your plan

4. Get a flu shot

5. Get any other covered and necessary annual immunizations

Using Your FSA

Unlike with a Health Savings Account (HSA), most plans do not allow an FSA to rollover. This means, if you don’t use all your FSA funds by the end of your plan year, you will lose them. If you have an FSA and need to use up remaining funds, here are some easy suggestions:

1. Book any appointments now and prepay them where possible. This includes deferred dental work, mental heath or physical therapy sessions, eye exams, hearing exams, etc. You can use FSA funds for copays and other costs.

2. Stock up on qualified items you may use for good health throughout the year. This includes contact lenses, first-aid supplies, period products, insulin, allergy medications, and other over-the-counter medications. Some medical devices can also be bought with an FSA, such as blood pressure monitors, PPE items, and cholesterol test kits. 

3. Get some new eyewear. Did you know that you can buy glasses or prescription sunglasses with FSA funds? Yep! This is an easy and quick way to use up remaining funds.

Preparing for the Next Plan Year

The other really smart thing to do during Q4 is to prepare for the next year and how to use your health plan. This is especially true if you recently changed healthcare plan providers, your insurance network changed, your health changed, or you have transitioned to Medicare.

Here are some easy ways to help prepare for how to use your healthcare plan next year:

1. Review your healthcare needs and try to outline what you may need to budget for in the coming year

2. Review your current plan including expenses, doctor visits, medications, etc., to estimate your needs for 2026, identify potential coverage gaps, and make a schedule

3. Check your provider network to ensure that your preferred doctors, specialists, and hospitals are still in the network. If your network  has changed, now is also a good time to research other options.

4. Max out your HSA if you’re eligible to contribute to one. These are tax-free contributions, and tax-free when you use them on eligible services and healthcare items.

Get the Most From Your Health Plan

If you are not sure what the best option is for maximizing your health plan benefits give us a call at 972-394-8844 or contact us online here. Or if you are, and need to set up an appointment with our team today, use our easy-to-use online scheduling tool.