The National  Memo Logo

Smart. Sharp. Funny. Fearless.

Monday, December 09, 2019 {{ new Date().getDay() }}

While the holiday season usually involves spending on gifts, feasting, and parties along with other festive (and perhaps not so healthy) indulgences, the end of the year can also bring significant savings on annual health costs — especially for consumers who understand the details of their own insurance coverage.

The first and potentially most lucrative target is the annual deductible – the amount that your plan requires you to pay in out-of-pocket costs for medical procedures, tests, or other services before the insurer pays all (or almost all) additional health expenses. Knowing the amount of your plan’s deductible, which can vary widely from hundreds to thousands of dollars annually, apportioned either individually or for your entire family, is essential to minimize costs and maximize benefits.

For most plans, the deductible rolls over again on January 1, meaning that you will need to climb that same financial hill again as soon as the new year begins. (Some plans, such as those obtained through a school or university, may use the academic year instead – check with your insurer to be certain.) And most consumers are likely to meet the deductible toward the end of the year – which means that now is the time to take advantage of whatever elective procedures or services you or your family members may need that can be obtained for free or very low cost.

As soon as your health spending reaches the deductible amount — whether that comes to $500 or $5,000 — it makes eminent sense to arrange those procedures or services in most cases before December 31. Medical providers know by now to expect a rush of visits before year’s end, and many will set up additional office hours to meet the demand.

But be certain that you know the specific rules governing your plan before making any appointments, because various preferred provider plans may require separate deductible amounts for in-network and out-of-network care. The same caution applies to family policies, which may include either combined or separate deductibles for each covered family member.

Even if you have reached the in-network deductible, you may still have to pay for out-of-network providers, or vice versa. And always find out whether the physician you’re seeing is in or out of network before your appointment – neglecting to check can turn out to be very expensive. It’s also wise to check that everything involved is in network… even if your initial appointment is with an in-network physician or facility, you may well get a surprise bill later if they send your tests (especially in the case of MRI or X-ray films) to an out-of-network provider to be read or evaluated.  

Similarly, dental and vision plans as well as flexible spending accounts almost always offer benefits that must be used before the new year begins. Check with your insurance plan’s customer service department, either by phone or online, to determine whether you are eligible for unused benefits – for instance, a new pair of glasses or contact lenses, or a dental cleaning.

Every insurance plan must now provide a simple summary of benefits and coverage, similar to this sample sheet published by Consumer Reports. The summary should quickly enable you to find the deductibles, benefits, and co-payments included in your plan. But you are still likely to have questions, so don’t hesitate to contact your insurer for clear and specific answers.

With the passage of the Affordable Care Act, nearly every insurance plan is now required to provide a schedule of free or very low-cost preventive health benefits for menwomen, and children  including annual checkups, blood pressure and cholesterol screening for adults, several kinds of vaccinations, tobacco cessation services and more – a complete list can be found here.

For Medicare Part B patients, a yearly “wellness” visit  designed to monitor your vital signs, weight, and other health indicators is also free, with no co-pay. Patients newly signed up for Part B are entitled within their first 12 months of coverage to a “Welcome to Medicare” preventive care visit that includes height, weight, and blood pressure measurements, a body mass index calculation, a vision test, a review of depression risk, a discussion of advance directives, and a written plan that outlines the screenings, inoculations, and other preventive services you may need in the coming year.

AFP Photo/Joe Raedle

Advertising

Start your day with National Memo Newsletter

Know first.

The opinions that matter. Delivered to your inbox every morning

Crime scene outside Cincinnati, Ohio where state police shot FBI attacker Ricky Shiffer

Youtube Screenshot

Ricky Shiffer was like a lot of MAGA “patriots,” often proclaiming his willingness to die for Donald Trump. Like seemingly all Trump fans, he was outraged that the FBI served a search warrant on the ex-president’s Florida estate, eager to declare “civil war” on “the Deep State.” Shiffer was such a True Believer that on Thursday, he tried to attack the FBI office in Cincinnati, Ohio, and ended up dying next to a cornfield a few miles away.

Shiffer believed he was dying a martyr to the cause. But his only reward was for the community of terminally online Trumpists with whom he spent his time to immediately denounce him as a “crisis actor” who had performed a “false flag” operation with the sole purpose of smearing MAGA people by association.

Keep reading... Show less

Former President Donald Trump

Youtube Screenshot

Most Americans have long believed former President Donald Trump perpetrated multiple felony offenses both before and after entering the White House, according to opinion surveys — and yet those same citizens have also assumed that Trump would never be held accountable. But just at the moment that his escape from the law no longer seems quite so certain, the Republicans have almost all fallen into line behind him like lemmings.

There can be little doubt that the former president is in deep legal trouble. To evade the law, he is employing his usual tactics, from slick spin to torrential lying to feigned outrage to threats of mob violence, but mostly delay.

Keep reading... Show less
{{ post.roar_specific_data.api_data.analytics }}