Health Insurance has gotten a lot more complicated. Many aspects of insurance have changed quite a bit. The big one you need to pay attention to right now is your deductible. If you don’t understand your deductible, this somewhat complicated issue can cost you a lot.
Most health plans these days require you to pay some of your medical costs. The deductible is one of the ways they transfer cost to you, the patient. Here is how it works: The insurance company sets a deductible for your plan – for example, $2000 a year. This is the amount you have to pay before your insurance company starts paying their portion.
Thanks to the ACA, insurance has to cover preventative care, birth control, and immunizations (and a few other things), but for everything else, you have to pay up to the deductible and then insurance will start to pay. If you have a $2000 deductible and you see a doctor for $450, you will have to pay that, and another $1550 before your insurance kicks in.
And here is the most important part – deductibles reset every year, almost always on January 1st. That means if you have paid for some healthcare this year, you can save a lot by getting any additional care you have planned done before 2017, when your deductible will reset.
There are 4 scenarios:
1. If you haven’t paid anything for healthcare this year: In this case it is appropriate to wait until January to avoid paying your deductible both in 2016 and 2017.
2. If you have paid part of your deductible, but you don’t have any current healthcare needs, or your costs will not be enough to reach your deductible prior to 2017: In this case it doesn’t matter. Unless you plan to have lots of costs in 2017, schedule any healthcare when most convenient. If you will have lots of costs in 2017, then wait until January.
3. If you have met your deductible: This is true for many people. Because you don’t still owe your deductible, your coverage will be much better in December than it will after your deductible resets in January. Get to your healthcare providers now!
4. If you have paid part of your deductible, and your planned care costs will be more than your deductible minus what you have already paid: Your insurance will kick in faster if you get started now, rather than waiting and having to start at zero. Go see your provider now!
Obviously if you have immediate needs, get them addressed. Don’t let a difference in costs cause significant damage to your health.
The bottom line, if you have paid any portion of your deductible and have any significant healthcare needs, try to fit them into December so you can save money. Best wishes in this holiday season! May your health be fantastic.