Plan Year Ending Soon? Make the Most of It

If you’re the kind of person who needs a deadline to get things done, there may be a big one just around the corner. If your health plan year is ending soon, it’s a good time to review your health benefits.

Doing so could be a boost to your overall health — and could even save you money. That’s because you might have benefits you want to use before the end of the plan year. It pays to check it out and make a few appointments.

Deductibles

Looking at your health benefits now may save you money. If your plan has a deductible and you’ve met it, you might want to schedule care your doctor has been recommending now, rather than waiting until your next plan year.

A deductible is the amount you pay for health care services each plan year before your health plan starts to pay. For example, if you have a $1,500 deductible, you pay the first $1,500 of the services you need.

Once you’ve met your deductible, you usually pay only a copay and/or coinsurance for covered services. Coinsurance is when your plan pays a large percentage of the cost of care and you pay the rest. For example, if your coinsurance is 20 percent, you’ll pay 20 percent of the costs when you need care. Your health plan pays the other 80 percent.

Since your deductible resets each plan year, it’s a good idea to keep an eye on the figures. If you’ve met your deductible for the year or are close to meeting it, you may want to squeeze in some needed tests or procedures before your plan year ends to lower your out-of-pocket costs.

If you have had a lot of medical expenses this year, you may have also met your out-of-pocket maximum. If that’s the case, you may not have to pay anything for in-network services covered by your plan. So you'll save even more on treatment you’ve been putting off.

If you wait until your new plan year starts for the same treatment, your deductible and your out-of-pocket will have reset. That means you will have to pay more out of pocket for the very same care.

High Finance

The end of your plan year is also a good time to review your financial paperwork.

Members with employer-sponsored plans may have a Flexible Spending Account balance that needs to be used before the end of the plan year. A Flexible Spending Account, or FSA, is an employer-sponsored option that lets you set aside a part of your earnings before taxes for qualified medical expenses. Qualified expenses include doctor’s visits and products such as contact lenses and prescription glasses.

Using an FSA may save you money. But pay attention to the calendar. FSA money is often a “use-it-or-lose-it” benefit. Sometimes FSA money will roll to the next plan year, but check with your benefits department to make sure.

For both employer-sponsored and individual plans, a Health Savings Account is also money set aside to be used for qualified health care costs. But any money you don’t spend can be rolled to the next plan year.

Find out more about flexible spending accounts and health savings accounts.

Keep Smiling

It’s nice to have a clean report from the dentist, no matter your age. If you think you might need to have some work done, now’s a good time to check it out. If you have a dental plan, double check your yearly maximums. If you expect to need fillings, crowns or root canals, you might want to plan them in the current plan year to use your available funds.

Some people have one procedure at the end of one plan year and the next at the beginning of the new plan year to break the treatment into two different plan years. It’s an efficient, cost-effective way to use your benefits.

Sources: Health Checkup,  U.S. National Library of Medicine, 2024; Year-End Tips to Maximize Your Health Benefits,  JDRF.org, 2022