BHealthy Blog

Are You Getting the Most Out of Your Insurance Plan?

Nobody wants to spend the holiday season in a clinic or a hospital, but now may be the right time to make the most of your insurance benefits.  But, unfortunately, when it comes to many of those benefits, you need to use it to maintain it in the new year.

Many aren’t familiar with all of the benefits their insurance policy provides. 

I’d say that most people don’t get the most benefits provided by their health plans, myself among them,” said Dr. Upton Siddons, a family physician at Baptist Health Family Clinic-Greenwood. “Some coverage plans include monthly or annual stipends for purchasing medical supplies or provide incentives in the form of cash, gift cards, or reduced fees for patients that come in for annual check ups or discuss certain health issues with their health care providers.” 

It’s important to thoroughly review your policy with an insurance agent or the benefits department of your workplace if you are insured through an employer. 

Your Deductible

By the end of the year, most people have met their deductible, or the amount they pay for covered health services before their insurance plan starts to pay. If that’s the case, you may be able to pay less for some health care services. So, if there is a procedure, test or visits with a provider you’ve been putting off because of cost, now is the time to schedule an appointment or ask your provider for a referral. 

Some insurance plans have separate deductibles for medical care and prescription drugs. If yours does, and you’ve met your pharmacy deductible, see if you can refill prescriptions before January 1. Some insurance plans and employers also require an annual wellness exam and certain vaccinations by a certain date, usually in the latter part of the year.

Dental and Vision 

With all of those sweets on the menu, now is also a good time to visit the dentist. If you are in need of dental work, but your insurance only pays a certain amount a year, you may be able to have part of the procedures done this year and schedule the rest for the new year. When it comes to vision insurance, most will pay for new contact lenses or eyeglasses each year. Review your plan details to see what’s covered and within what time frame. Be sure to take advantage of the benefits for each dependent on the insurance plan.

Spending and Savings Accounts

You may have enrolled in a flexible spending account (FSA) or a health savings account (HSA). An FSA is for healthcare costs for you and your family. This includes copays for provider visits, as well as some over-the-counter products such as cold medicine, personal protective equipment (PPE), heating pads or even sunscreen. FSA accounts don’t roll over, so check your balance and make sure you’re spending the balance of your account. If you still have money in the account that needs to be budgeted to be spent by the end of the year, check out this comprehensive list of FSA-eligible purchases.

An HSA is a type of personal savings account you can set up to pay certain health care costs. This type of account allows you to put money away and withdraw it tax-free, as long as you use it for qualified medical expenses, like deductibles, copayments, coinsurance, and more. HSA funds roll over year to year if you don’t spend them. An HSA may earn interest or other earnings, which are not taxable.

Do Your Homework 

“Health insurance plans can be confusing to navigate and I find most plans leave it up to the patient to do the homework to make sure benefits aren’t left on the table,” said. Dr. Siddons. 

This time of year, you’re also likely enrolling in benefits for next year. It can all be confusing and overwhelming, but if your employer offers benefits counselors in person or by phone, take advantage of the help. These counselors can help answer any questions about the benefits you need for you and your family.

“My advice would be to sit down for an hour sometime this weekend with a warm drink and review the benefits your insurance plan provides, noting whether they expire at year’s end or roll over into the next,” said Dr. Siddons. “You may also consider talking with an agent about whether there are alternative plans that are more tailored towards coverage of a specific disease process, such as asthma or diabetes.”

Whether you’re wrapping up your benefits for this year or making choices to enroll in a plan for next year, it’s essential to read through your benefits guide and talk to someone about what options fit your health and your life. Then, contact your employer or visit to review plans.