End of Year Reminder: Insurance Deductible Resets

Health insurance can sometimes feel like a library of complex terms, conditions, and numbers. One of the often-misunderstood terms is the “deductible.” Understanding health insurance deductibles and their year-end resets is important for making the best decisions about your healthcare expenses.  

A health insurance deductible is the amount you must pay out-of-pocket for covered medical services before your insurance plan starts to contribute. It’s like the threshold you need to cross before your insurance plan kicks in.

How Does It Work?

For instance, let’s say your health insurance plan has a $1,000 deductible. This means you’ll be responsible for paying the first $1,000 of your medical bills for covered services. After that, your insurance will start sharing the costs. This doesn’t mean you’ll pay $1,000 for every medical expense; it’s the cumulative amount you need to cover before your insurer starts to pay its allotted portion.

Different Types of Health Insurance Plans

Different types of health insurance plans have various deductible structures. High-deductible plans typically have lower monthly premiums, but higher deductibles, while low-deductible plans have higher premiums and lower deductibles. It’s important to choose a plan that aligns with your healthcare needs and budget.

The Significance of the New Year

An important aspect of health insurance deductibles is the year-end reset. Many insurance plans reset deductibles on December 31st each year. This means that every January 1st, your deductible starts fresh, and you’ll need to meet it again before your insurance starts covering your expenses. While December 31st is very common, some plans may reset on a different date. Always check your plan’s terms and conditions to ensure you’re aware of when your deductible resets.

Why Do Deductible Resets Matter?

A year-end deductible reset can have a big impact on your healthcare costs, especially if you have met your deductible by the end of the year. This creates an opportunity for cost savings, as you can schedule necessary doctor’s visits, medical tests, treatments, or procedures before the reset to maximize your insurance coverage. Year-end resets can limit your out-of-pocket expenses greatly. By timing your medical expenses accordingly, you can minimize any personal financial responsibility and make the most out of your health insurance coverage. 

Imagine you have already met your $2,000 deductible, and it’s November. In December, you need a medical test performed, costing $2,000. Since you have already met your deductible, your insurance will cover a significant portion of the expense, leaving you with a lower out-of-pocket cost.

Maximizing Your Benefits

To maximize your insurance benefits, consider scheduling medical procedures, tests, or treatments that you’ve been planning before the year-end reset if possible. This way, you can leverage your insurance coverage more effectively.  

Make sure you plan your healthcare expenses accordingly. If you are close to meeting your deductible, consider scheduling any appointments to ensure your insurer covers most of the costs.  

Always research where you are going for your procedure, test, or treatment. Prices can vary significantly between healthcare providers, so it is important to do research to find cost-effective options. In many cases, hospital-based services cost more, while outpatient centers provide a more cost-effective option. If you are referred to a particular specialist by your primary doctor, discuss your options with them to explore a better fit for you.

How Do I Know If I Have Met My Deductible?

Knowing if you’ve met your deductible can be tricky and lead to confusion surrounding your financial responsibility for your healthcare usage. You can typically check your deductible progress through your insurer’s online portal or by calling their customer service. Review your Explanation of Benefits (EOB) statements, which detail the payments made by your insurance company and the amount you still owe.  

If you have a family health insurance plan with multiple members, remember that the family deductible will usually combine all family members’ healthcare expenses. So, if one family member has met their individual deductible, their expenses can contribute to meeting the family deductible.

Looking Ahead

Understanding your health insurance deductibles isn’t just about the present; it’s also about planning for your future healthcare needs. Life is unpredictable, and unexpected medical expenses can arise at any time. Stay prepared by understanding your insurance coverage and how your deductible works. This knowledge will help you make the best decision when emergencies occur.

Choosing South Jersey Radiology

South Jersey Radiology Associates (SJRA) has 16 convenient locations throughout the South Jersey and Philadelphia area, offering diagnostic and advanced medical imaging services up to 60% less than hospital-based centers. With evening and weekend appointments available, you can maximize your cost savings before the year-end deductible reset. Schedule your appointment at any of the following offices today:  

• Cherry Hill Office – Cherry Hill, NJ
• Haddonfield Office – Haddonfield, NJ
• Marlton (Greentree) Office – Marlton, NJ
• Medford Office – Medford, NJ
• Moorestown Office – Moorestown, NJ
• Mount Laurel Office – Mount Laurel, NJ
• Turnersville Office – Turnersville, NJ
• Route 73 (Voorhees) Office – Voorhees Township, NJ
• Voorhees (Carnie Boulevard) Office – Voorhees Township, NJ
• Sewell (Washington Township) Office – Sewell, NJ
• West Deptford Office – West Deptford, NJ
• Willingboro Office – Willingboro, NJ
• Women’s Center at Cross Keys – Sewell, NJ
• Women’s Center at Medford – Medford, NJ
• Women’s Center at Mount Laurel – Mount Laurel, NJ
• Women’s Center at Voorhees – Voorhees Township, NJ

Learn more about the board-certified, subspecialized radiologists who read, analyze, and interpret our studies here at SJRA.