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Dec 03, 2014

Did you hit your health insurance deductible this year? As we near the end of the year…chances are, you didn’t get anywhere near your deductible or out-of-pocket max. 

To help out this year AND next year (it’s never too late to start planning!), we’re answering some frequently asked questions to make sure you get the most out of your policy with the least impact on your budget!

TIP #1: Start with the basics.

Be sure to have your annual physical and ladies, get your mammogram (click here to read an article I wrote about the importance of making sure the girls are healthy!). If you have vision and dental insurance, get your eye exam and cleaning. All of these preventive services are covered under most insurance policies, so if you don’t do it, you’re wasting your hard-earned cash!

TIP #2: Consider more than the basics.

If you’re considering some last minute non-emergency surgery, but haven’t reached your deductible, don’t do it now – wait until the first of the year (or the beginning of your plan year). Let’s say you have it done in January instead. You’d have time to plan it, budget it, schedule it - and you could meet your deductible and/or out of pocket max in the first few months of the year, leaving the rest of the year’s medical expenses paid for by your insurance (well, most of them depending on your insurance plan). At the least, the costs will go toward your deductible and out of pocket max for the rest of the year.

If you’ve already reached your deductible, this doesn’t necessarily mean every medical expense is now covered! Be sure to review your policy for the difference between your deductible and your out-of-pocket maximum. Then, get an estimate on the cost of the procedure to see if it makes sense to do it now or wait until next year. You’ll probably still want to have it done now since insurance will likely pay the bulk of it. Consider enlisting the help of a Medical Health Advisor service with experts who can organize and get cost estimates on a procedure.

TIP #3: Get it done!

If you’ve reached your out-of-pocket max for the year, get EVERYTHING taken care of before the end of the year since your insurance will be paying for it (well, most of it depending on your insurance plan).  A few tips:

**Tell your doctor you’ve reached your out-of-pocket maximum for the year and ask if there’s any follow-up care that can be booked and billed prior to 12/31.

**Book your procedure NOW! Many people are doing last minute procedures for this same reason - you could say it’s like Christmas for hospitals. If you can’t get a confirmed booking, ask to be on the cancelation list.

**Be sure to keep all your receipts and check with your tax preparer or accountant – high medical expenses can be tax deductible.

TIP #4: Reconcile your accounts.

There are many types of financial accounts that allow Americans to put money aside for medical expenses. Do you know what your balances are? Do you know when they expire? This might help…

An FSA (Flexible Spending Account) is “use it or lose it.” In other words, if you don’t spend every dollar by the end of your plan year, *poof* it all goes away. If you saved a little extra this year for a procedure and haven’t done it, NOW is the time.  

If you have money in the FSA account but no foreseeable medical expenses, here are a few ideas: an extra pair of glasses, 

• stock up on contacts

• have some dental work done

• refill some prescriptions

• get a hearing test 

• try an alternative treatment like acupuncture or chiropractic, etc. 

• Aetna has a nice chart you can scan for other ideas on how to spend that money burnin’ a hole in your account!

An HSA (Health Savings Account) can roll over to next year and the next year and so on. It’s like an IRA for your healthcare, so let it roll over and build up so it’s there when you really need it. Also, since the money is tax-deferred, putting more into your HSA at the end of the year can be a great investment vs. paying taxes on it as income. Check with your tax preparer or accountant to see if it’s a good idea for you!

An HRA (Health Reimbursement Arrangement) is a program some employers provide for employees to help pay for healthcare expenses. If you have an HRA, your employer probably adds money to the account each year. Here’s the deal: that money isn’t really yours. It’s owned by your employer and you can only use it as long as you’re employed there. Are you considering a job change? If so, use the money before you leave! Once you walk out the door, the funds are no longer available to you. If you’re planning to stick around at your job for a while, let it roll over to the next year and use it when you have more of a need. Some employers specify which medical expenses the HRA funds can be used for, so be sure you know your employer’s rules (for instance, they could say they only want it used for medical expenses – vision and dental expenses are excluded).

As insurance and healthcare costs continue to skyrocket, we can all use some help in being better consumers in this area. 

What tricks do you have for getting the most bang for your insurance buck at the end of the year? Any tax tips you’d like to share? Comment below or email me at if you have a question!


Heidi has a passion for helping busy families control their healthcare dime, time and peace of mind! She writes articles to do just that, while keeping it fun and simple for her readers! She also speaks on healthcare issues and is the owner of

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