What Does It Mean When Deductibles Reset?

November 14, 2022 – 5 min read

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Woman Speaking With Benefits Manager To Talk About Deductible Reset

An unexpected bill for medical services can quickly ruin anyone’s day. Your health insurance plan outlines a deductible schedule that may be able to explain why you received an unexpected bill. Insurance deductibles have a direct effect on how and when you should schedule your diagnostic imaging center appointments. With the year-end months of October, November, and December upon us, it is important to understand what a health insurance deductible reset means for you.

What Is The Difference Between A Deductible And A Premium?

Deductibles and premiums are terms that get thrown around a lot when it comes to health insurance. Both line items are important to understand. A deductible is the dollar amount you are responsible for before your health insurance plan kicks in. If you have a $1,000 deductible, you pay the first $1,000 of your medical services before your insurance covers the rest. Private heath insurance plans and certain parts of Medicare have deductibles as well as other cost sharing options.

So, what is a premium? A premium is the amount you pay monthly to maintain your health insurance coverage. On your paystub, you can see how much money is taken out for your health insurance premium. Your health insurance premium varies based on the type of insurance you have and the extent of your coverage. In most cases, you must pay other costs associated for your health care such as a deductible, copayment, and coinsurance.

How Does The New Year Affect My Deductible?

Many health insurance plans follow a calendar year deductible schedule. Why does this matter? The medical expenses you have paid towards your annual deductible throughout the year reset on January 1st of each year. In other cases, a health insurance plan may follow a plan year schedule. A plan year schedule is when your medical expenses paid towards your deductible reset on the day your health insurance policy renews rather than January 1st. Understanding your deductible schedule can help you avoid unexpected expenses from a medical visit. If you are planning to wait until after the holidays to get an imaging study done, you may want to think twice.

Are There Any Rollover Options?

Certain health insurance plans offer a rollover option or a carryover provision, for the last quarter (October – December) of the year. A rollover option allows for medical expenses incurred during the fourth quarter of the year to roll over and count toward your deductible for the new year. A rollover option can make appointments during the last months of the year a lot more manageable for you. If you are unsure if your health insurance plan has or offers a rollover option, reach out to your provider.

At South Jersey Radiology, we understand the end of the year can be a crunch when it comes to financial planning. To ensure your imaging study applies to this year’s deductible, it is important to schedule your appointment for an imaging study prior to January 1st. SJRA has 16 locations across the South Jersey area that offer evening and weekend hours so you can get your imaging study done on time. If you are ready to schedule your appointment for a screening or advanced imaging study, please reach out to any of our following locations:

Learn more about the board-certified sub-specialized radiologists who read and interpret studies at SJRA here.

Frequently Asked Questions

What is the difference between a deductible and a premium?

A deductible is the amount you are responsible for paying before your health insurance plan starts covering your medical expenses. It is a set dollar amount. On the other hand, a premium is the monthly fee you pay to maintain your health insurance coverage. It is an ongoing cost that you pay to have insurance.

How does the new year affect my deductible?

For many health insurance plans, the deductible resets at the beginning of the calendar year, usually on January 1st. This means that any medical expenses you have paid towards your deductible throughout the year start over, and you need to meet the deductible again. Some plans may follow a plan year schedule where the deductible resets on the day your health insurance policy renews. Understanding your deductible schedule helps you plan and avoid unexpected expenses.

Are there any rollover options for deductibles?

Certain health insurance plans offer a rollover option or carryover provision for the last quarter of the year (October – December). This means that medical expenses incurred during this period can roll over and count toward your deductible for the new year. It is essential to check with your provider to see if your health insurance plan has a rollover option.

How should I schedule my imaging study to ensure it applies to this year’s deductible?

To ensure your imaging study applies to the current year’s deductible, it is advisable to schedule your appointment before January 1st. South Jersey Radiology Associates (SJRA) offers 16 locations across the South Jersey area, including evenings and weekends, for your convenience. Contact any of our locations to schedule your diagnostic or advanced imaging study.

Who reads and interprets the imaging studies at SJRA?

Our team of board-certified, subspecialized radiologists reads and interprets all imaging studies. You can learn more about our radiologists by visiting our physician profiles.

Larchmont Imaging and SJRA have united to elevate patient care across South Jersey!

For over 80 years, both Larchmont Imaging and SJRA have been recognized for their state-of-the-art technology, industry-leading subspecialized radiologists, and exceptional patient care. 

What does this mean for you?

  • Our new, combined footprint now includes 16 convenient locations across Burlington, Camden, and Gloucester counties to serve you better.
  • Enjoy more locations with flexible appointment times, including early mornings, evenings, and weekend hours, to accommodate your busy schedule.
  • Benefit from increased availability of same-day and next-day appointment times for quicker imaging results.
  • Schedule your appointments online, 24/7, for greater convenience.
  • Access the highest quality imaging services, typically only offered at hospitals, at costs up to 60% less.

You will continue to have access to the same compassionate office team, highly trained technologists, and experienced radiologists you’ve known and trusted for years.

Thank you for entrusting us with your care. We are excited to continue this legacy together as SJRA to serve our community even stronger.