Health insurance reminder: Fall is 'use it or lose it' time

By Teri Dreher
Patient Advocate
Updated 10/20/2019 9:09 AM

Chances are, you pay dearly for your health insurance -- and you want to get the most from your investment. But many health-care consumers forget that some health-care benefits disappear at the end of each calendar year, which makes autumn is "use it or lose it" time. To make sure you're not forfeiting any benefits, ask yourself these five questions.

1. Have you met your health plan deductible?


If you've already met your 2019 health-care deductible, you'll want to take care of any needed doctors' appointments before year end. Once you've paid your deductible, expenses are paid by your insurance carrier (minus coinsurance and copays), greatly reducing your out-of-pocket costs.

But make those appointments now. Doctors' schedules get packed this time of year for this very reason. Remember, on Jan. 1, 2020, your deductible will reset to $0, and you'll be required to meet it all over again.

2. Have you received your preventive services?

Many health plans provide a number of no-cost preventive care services, such as screenings and vaccines received during a physical (although the visit itself may be subject to a co-pay). These also include mammograms, well-woman care and colonoscopies for people between 50 and 75 years old.

You may be entitled to free preventive services once per calendar year or every 365 days. While many doctors will send patients reminders, it's up to you to keep track of what you're entitled to and when you received it.

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3. Have you met your dental plan's benefit maximum?

Most dental plans feature an annual maximum of $1,000-$3,000, which resets at the end of the year. According to the American Dental Association, only 2.8% of people with PPO dental plans actually use all their benefits! The rest are leaving money on the table.

If you're due for a checkup, or your dentist has indicated that you'll eventually need some dental work, put those unused dental benefits to work -- make that appointment now.

4. Do you have funds left in your FSA?

Do you have a Flexible Spending Account, or FSA, which you've funded with pretax dollars to cover outstanding health-care costs? While some FSAs let you roll over up to $500 to the next year, or give you a grace period, most don't -- which means you'll forfeit unused funds.

So, make sure you've submitted all of your out-of-pocket health care expenses -- copays, coinsurance, prescription drug costs -- for reimbursement. Dental and vision care expenses, too. You can even use remaining funds to stock your medicine cabinet with OTCs for 2020. Just do it before year end.


5. Did you take all your vacation days?

OK, this one isn't strictly a health insurance benefit, but taking time off is good for your health. Among other things, vacations have been proven to reduce stress and improve heart health. Don't be one of the 50% of Americans who forfeit precious time off. Use it, don't lose it. Your mind and body will thank you.

One final thought, for Medicare beneficiaries

Medicare beneficiaries want the most from their benefits, too. Each fall, open enrollment is an opportunity to reevaluate whether your Medicare/Medicare Supplement plans are your best, most cost-effective choice -- given your current health conditions and medications. There are some significant changes to Medicare this year, so it's especially important to conduct a thorough evaluation. If you're out of your depth, ask for help!

• Teri Dreher, RN, CCM, is a Board Certified Patient Advocate (BCPA) and pioneer in the growing field of private patient advocacy. A critical care nurse for more than 30 years, today she is owner/founder of NShore Patient Advocates,, the largest advocacy company in the area. She is the author of "Patient Advocacy Matters."

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