Elective GI procedures could be much more affordable if you schedule them at the end of the year after you have met your deductible. Your annual healthcare deductible is the amount you must pay out-of-pocket each year for covered medical procedures before your insurance will begin paying. Most deductibles reset on January 1 each year, so this is the time to evaluate whether you should schedule that GI procedure or wait until next year.
You may think you do not have time to call your insurance company about your deductible, but a few minutes of research could save you thousands of dollars, particularly if you have a high-deductible health plan (HDHP) or a Flexible Spending Account (FSA).
Here are four scenarios you may be facing as you approach the end of the year:
You have already met your deductible, or you are close to meeting it.
You should consider scheduling that upper endoscopy or other diagnostic test as soon as possible. If you have already met your deductible, you will pay less now than if you wait until next year. If you are approaching your deductible, call your insurance company to ask for an estimate of costs so you can prioritize things like outpatient surgery, diagnostic testing, lab work and prescription refills.
You will not meet your deductible.
If you are not close to meeting your deductible, you may choose to delay procedures and appointments so your expenses can count toward next year’s deductible.
However, there is no reason to delay preventative screenings like colonoscopies. Under the Affordable Care Act, screening colonoscopies (and related anesthesia and sedation) are covered at 100 percent for private insurance and Medicare.
You have a surplus in your Flexible Spending Account (FSA).
If you have an FSA through your employment, check your balance regularly and use all funds before the end of the year. FSA money does not roll into next year, and you will lose all unused funds. You may opt to schedule a GERD treatment like an esophageal dilation. Click here to get a comprehensive list of qualified medical expenses for which you can use your FSA dollars.
You have additional funds in your Health Savings Account (HSA).
HSA funds can be rolled over into next year, so you do not need to rush to use that money right away. You may want to accumulate money in your HSA for a more expensive elective digestive procedure in the future.
Call Your GI Doctor
Understanding your health plan is the first step in making it work for you. Call your insurance provider, and then contact your GI doctor to schedule your elective digestive procedure. Quality healthcare can be more affordable when you pay attention to your deductible.