Schedule your checkups and refills before the year ends.
Buy and wrap presents? Check. Drink the eggnog and spend time with loved ones? Check. Schedule a doctor’s appointment by Dec. 31. Why?
With all there is to do, you still might want to squirrel away an hour or two to get that last-minute checkup in. With many insurance plans resetting in the new year, along with health insurance deductibles, you might be able to save some money by scheduling a last-minute appointment or get that last prescription refill, some experts say – especially if you have already exceeded your deductible.
Deductibles are those pesky and possibly confusing numbers that tell you how much you have to spend out of pocket on health care costs before your insurance provider starts paying its share. For many plans, deductibles reset on Jan. 1 of each year.
If you need a checkup or require medical supplies or a prescription refill and you’ve already surpassed your deductible for the year, it’s probably a good idea to take care of these issues in December rather than waiting until January, according to Aengus Adams and Kristy Clark, staff agents at David M. Gilston Insurance Agency in Charleston who are experts in helping people pick insurance plans.
Some plans cover at least a part of your costs for doctors’ appointments before you reach your deductible. Typical plans come with $4,000 to $6,000 annual deductibles, Adams said. With catastrophic plans, deductibles are generally much higher, and, therefore, are less likely to be met, he said. Catastrophic plans focus on serious health problems and may only pay for a few primary care visits per year.
If you’ve met your insurance plan’s deductible for the year or are within reach of meeting it, “I recommend ordering everything you need, like CPAP supplies,” Adams said. Try to obtain a 90-day supply of your prescriptions to get you into the new year, he suggested.
Consider screenings and appointment availability
If you haven’t had your annual physical or screenings, this may be a good time to get those checked off, suggested an online article by Southwest Healthcare, a hospital system in Temecula, California. For men, for example, an annual prostate screening could cost between $100 and $300 in many parts of the country. Year-end appointments book fast, the article notes, so it’s wise to schedule them in advance.
Regardless of whether you’ve reached your deductible for this year, you should check to see if your plan is changing in the new year. You might even want to change to a different provider in 2026, depending on your unique health care requirements. If your plan is changing or if you have decided to move on to another option, it may also make sense to book that year-end appointment, Adams said. Every year, about one to three health care plans go away and others are added, he noted.
With health care costs rising, Clark said she sees higher deductibles in the forecast for health insurance plans as an alternative to raising premiums.
Know your plan’s reset rules and spending accounts
For some employer-sponsored plans, especially of smaller employers, deductibles don’t reset on Jan.1; instead, their benefit years start at other times of the year, Clark pointed out. All individual plans – the ones you buy yourself as opposed to through your employer – have deductibles that reset on Jan. 1.
If you have a tax-exempt health care spending account, Clark said it may include incentives to get your business done by the end of the year. With traditional Health Reimbursement Arrangements, or HRAs, funds roll over into the new year, while with Flexible Spending Arrangements and Health Savings Accounts – FSAs and HSAs – they do not. In other words, what you don’t use, you lose, Clark said. HSAs can be used to pay for most medical, dental, vision and prescription drug coverage, but not premiums, and FSAs can also pay for many of these expenses.
Most Medicaid recipients don’t have deductibles, so there’s no financial incentive to book your year-end appointments, Clark said.
If you’re not sure if taking care of business by year-end will save you money, check your plan for details, Adams and Clark suggested.
By Kevin DeValk
