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Doing so could be a boost to your overall health — and could even save you money. That’s because you might have benefits you want to use before the end of the plan year. It pays to check it out and make a few appointments.
Looking at your health benefits now may save you money. If your plan has a deductible and you’ve met it, you might want to schedule care your doctor has been recommending now, rather than waiting until your next plan year.
A deductible is the amount you pay for health care services each plan year before your health plan starts to pay. For example, if you have a $1,500 deductible, you pay the first $1,500 of the services you need.
Once you’ve met your deductible, you usually pay only a copay and/or coinsurance for covered services. Coinsurance is when your plan pays a large percentage of the cost of care and you pay the rest. For example, if your coinsurance is 20 percent, you’ll pay 20 percent of the costs when you need care. Your health plan pays the other 80 percent.
Since your deductible resets each plan year, it’s a good idea to keep an eye on the figures. If you’ve met your deductible for the year or are close to meeting it, you may want to squeeze in some needed tests or procedures before your plan year ends to lower your out-of-pocket costs.
If you wait until your new plan year starts for the same tests, your deductible will have reset. That means you will have to pay more out of pocket for the very same care.
If you have had a lot of medical expenses this year, you may have also met your out-of-pocket maximum, so your insurance will pay a greater percentage of the total cost. If that’s the case, you may be able to save even more on any exam or procedure you’ve been putting off.
The end of your plan year is also a good time to review your financial paperwork.
For members with employer-sponsored plans, perhaps you have a Flexible Spending Account balance you need to use. A Flexible Spending Account, or FSA, is an employer-sponsored option that lets you set aside a part of your earnings before taxes for qualified medical expenses.
Using one may save you money. But pay attention to the calendar. FSA money is often a “use-it-or-lose-it” benefit. Qualified expenses include doctor’s visits and products such as contact lenses and prescription glasses. Sometimes FSA money will roll to the next plan year, but check with your benefits department to make sure.
For both employer-sponsored and individual plans, a Health Savings Account is also money set aside to be used for qualified health care costs, but it stays yours to use in the future. Any money you don’t spend can be rolled to the next plan year. Find out more about flexible spending accounts and health savings accounts.
It’s nice to have a clean report from the dentist, no matter your age. If you’re afraid you might need to have some work done, now’s a good time to check it out. If you have a dental plan, double check your yearly maximums. If you expect to need fillings, crowns or root canals, you might want to plan them in the current plan year to use your available funds.
Some people have one procedure at the end of one plan year and the next at the beginning of the new plan year to break the treatment into two different plan years. It’s an efficient, cost-effective way to use your benefits.
If you just can’t find room in your calendar this plan year, make yourself a pledge to get your annual exam early next year. That way, you can talk to your doctor about your total health, your risk factors and your family medical history. Those are the things that affect what health screenings you need each year.
Routine screenings are an important part of preventive health care. They can help spot a potential problem before it becomes a serious health issue.
If you have questions, there’s one place to go — your secure member portal, Blue Access for MembersSM(BAMSM). It offers information at your fingertips anytime. BAM lets you handle your health plan online. You can get easy access to whatever information you’re looking for. Stay organized and cut the time you spend looking for paperwork. One thing to check is your deductible amounts. That’s the amount you pay on some visits and treatments each year before your health plan starts to pay.
Next, check out My Coverage. You can view more plan details and print a proof of coverage letter. You can use the menu on the left to find out more about your pharmacy and other benefits.
The Claims Center tab lists your claims for the past 18 months. It’s also where you will find your claim statements or Explanation of Benefits (EOB) records. The statements will show the service supplied, what your plan covers, your financial responsibility and more.
While you’re logged in, you will be able to quickly view:
You can also make changes to your contact information or use the Provider Finder® tool under the Doctors and Hospitals tab to search for doctors and other providers in your network. Since you are logged in to BAM, you will see personalized search results based on your health plan and network.
Originally published 9/9/2019; Revised 2020, 2021
Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
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