Taking Advantage of Met Deductibles & Using FSA Dollars for Care
Posted November 29, 2021
Not sure how your health plan works, what your benefits mean, or how to make them work for you? You’re not alone. But we’re here to help! We’re breaking down what you need to know while there are still plenty of days left on the calendar to take advantage of some significantly reduced healthcare costs.
What is a deductible?
A deductible is the amount you spend out of pocket for medical expenses before your insurance kicks in to pay.
These days, many people are on high deductible health plans, meaning their deductible is more than $1,400 for individuals or $2,800 for families. If you’re on a plan with a $2,800 deductible and have spent more than that dollar amount on medical care this year, you’ve “met” your deductible and your insurance should now be lightening the load and helping you cover those expenses.
Got it. Once I’ve met my deductible, how much should my insurance cover?
It varies by plan. For some, meeting your deductible means your insurance covers the lion’s share, but you’re still responsible for a portion, or coinsurance. Let’s say your plan’s deductible is $2,800 and you have 20% co-insurance. Once your deductible has been met, your insurance will now cover 80% of your costs and you are responsible for the remaining 20%.
Alternately, some plans have copays, or a fixed amount paid for medical services. The copay amount may vary by type of service, but if you have a $20 copay on a doctor’s visit and the bill is $100, you will pay $20, and your insurance company will cover the remaining $80.
Not quite sure what the specifics of your plan are? You should be able to log into your insurance provider’s website or call the number on the back of your insurance card to get the specifics on your deductible, coinsurance, or copay.
So, what should I be doing to make the most of the fact that I’ve hit my deductible?
Any number of things! Many people deliberately wait to schedule certain visits or procedures until they’ve hit their deductible – think screenings, scans, preventative procedures, elective surgeries, etc.
If you’re due for a joint replacement, like a hip or knee, scheduling it after your deductible is met is a great way to save big. Physical therapy pre- and post- surgery should be part of that process, as it makes for:
- Improved surgical outcomes
- A lowered risk of post-operative infections
- Quicker recovery
- Reduced hospital stay
If you’re suffering from any unresolved aches, pains, sprains, or strains, now is a great time to come in. Just a few of the services we offer include:
- Hands-On Physical Therapy
- Sports Physical Therapy, Sports Performance Enhancement, and Athletic Training
- Chronic Pain Management
- Hand Therapy
- Women’s Health
- Workplace Injuries
- Dry Needling
Your pain is unique to your situation, so we don’t use the same treatment on everyone. Your dedicated physical therapist will develop an individualized treatment plan just for you, and then work with you so that you get the maximum benefit out of the time you put in. We’ll never just give you an exercise program and leave you to figure it out. More information can be found on the services we offer and how we do what we do by clicking here.
Any other tips or recommendations?
Yes! When you’re looking into your plan details, be sure to check whether or not you have a Flexible Spending Account (FSA) or Health Savings Account (HSA) set up.
FSAs & HSAs are great options for those looking to use pre-tax dollars to pay for medical procedures. Flexible Spending Accounts are set up through your employer and must be used by the end of each enrollment year, though some programs may have a short grace period once the year has expired. Don’t let those dollars go to waste!
Health Savings Accounts allow you to spend money on qualified health expenses or medical costs not at all covered by your insurance. Unlike FSAs, there is no deadline for withdrawing funds and anyone can set up an HSA.