Mid-Year Check-in: Are You Taking Full Advantage of Your Health Insurance Coverage?
8/8/2024
MOBERLY, MO – The midpoint of the year is a good time to review health insurance policies to ensure you will get the most out of plan benefits, especially if you have already met the annual deductible.
Many insurance plans will cover most, if not all, costs for eligible medical procedures and treatments once an individual meets the deductible and out of pocket maximum, making the second half of the year an opportune time to schedule any necessary or elective medical procedures that may have been postponed to reduce out-of-pocket expenses.
“Now is the time for everyone to take full advantage of the preventive care and other medical services available through their health plans,” said Michael Hall, Moberly Regional Medical Center CEO. “It’s a ‘use it or lose it’ situation, so now is the time to start utilizing all of the benefits before the year ends and deductible and out-of-pocket payment responsibilities reset.”
For example, someone who has a $2,000 deductible and a $4,000 out-of-pocket maximum is responsible for paying for many medical expenses until they reach the $2,000 threshold. Once they pass this mark, the insurer begins paying a larger portion of the cost of services eligible through in-network providers. And when they reach the $4,000 out-of-pocket maximum, insurers will pay the total cost for eligible services.
Remember, monthly premium payments do not count towards deductibles, and in most cases, copays do not count either. And once a new policy year begins, both deductible and out-of-pocket maximum contributions return back to zero.
Courtney Ramsey, FNP at Moberly Rural Health Clinic, which is a part of Moberly Regional Medical Center, highlights another critical aspect of leveraging health insurance benefits–preventative care.
“Whether your health insurance is through an employer, the Marketplace, or Medicare, preventative care is usually covered—including annual wellness appointments and immunizations,” said Ramsey. “While people may ‘feel’ healthy and skip their annual physicals, these appointments can discover underlying issues that might not yet show symptoms when they’re more treatable.”
Key screenings, such as mammograms and colonoscopies, and elective surgeries, such as joint replacements and hysterectomies, may also be less expensive once you've reached your deductible. But, plan early since sometimes these services can be harder to schedule during the second half of the year as more people catch up on their healthcare needs. And, in the case of surgeries, there may be a process that takes time before the procedure can be scheduled.
Whether you’ve already hit your deductible or you’ve been putting off seeing the doctor, the staff at Moberly Regional Medical Center can assist with better understanding and planning for out-of-pocket healthcare costs.
“We’re here to help the members of our communities make more informed healthcare choices,” added Hall. “While it’s not possible to anticipate exactly what it takes to restore someone’s health, or other issues that could arise from a visit or procedure, our patient access team can provide estimates for what one could expect to pay for care based on the insurance policy and the deductible status.”
To receive an estimate, call 660-269-3155.
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