VALPARAISO – During the fall and winter months it’s easy to get caught up in holiday planning and forget to take advantage of your insurance benefits. Every October, individuals should direct their attention to outstanding healthcare needs and take full advantage of paid-up deductibles or available funds in Flexible Spending Accounts.
“In considering their healthcare needs, people should also consider the best strategy for using their available health insurance plan benefits,” said Kathy Bandy, executive director of patient access for Porter Health Care System. “Now is the time to take advantage of unused benefits to complete outstanding treatments or recommended tests or procedures.”
Most health insurance plans have a deductible requirement—a predetermined amount of healthcare expense that must be covered before the plan begins paying the majority of (if not all) remaining expenses. Bandy says it’s crucial to know how close you are to meeting your deductible—or if you’ve already met it — “because once you reach that threshold, you have a limited window of opportunity to obtain healthcare services and have the bulk of that expense covered by your plan. Remember: a new year brings a new deductible,” she said.
The close of 2016 also affects individuals who have Flexible Spending Accounts (FSAs), which are pre-tax dollars set aside primarily for health-related expenses. The Internal Revenue Service requires those funds to be spent or forfeited by December 31. It’s a “use it or lose it” proposition, Bandy said.
If you have been putting off scheduling care, such as an annual check-up, allergy testing, or knee-replacement surgery, it would be wise to check your deductible status and your FSA balance to see if there’s money to be saved. In addition, now is a good time to check with your primary care provider to see if you are due for any recommended screenings or procedures, such as a colonoscopy, mammogram, or annual blood work. All of those require a physician referral, so you may want to schedule your doctor appointment now so the procedures can be scheduled before the end of the year.
“Getting everything squared-away by early December will help ensure the services you receive are considered part of your 2016 coverage,” Bandy said.
Every health plan is different. It is important to know how your plan works so you can get the most from your benefits. If you have a referral for a test or procedure and you aren’t sure what your cost would be to have it at Porter Regional Hospital, Portage Hospital, or affiliated Porter Health Care System facilities, you can contact a financial counselor at (219) 983-5012. If you do not have insurance and need assistance signing up or navigating the Health Insurance Marketplace, call (219) 983-8829 or visit porterhealth.com and click on About, then Eligibility Services.
