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Last year around this time, Jill realized that her father, whom she provides care for, hadn’t been seen for his annual check-up. Focused on managing his medication and specialist visits, it was challenging to prioritize assessing unused insurance benefits. With just a few weeks left in the year, Jill scrambled to secure an appointment. During the visit, a minor issue was detected early—fortunately before it could become a much larger problem.
Whether it’s scheduling a last-minute exam or discovering unexpected perks like gym membership discounts, this is the time to ensure your care recipient is benefitting fully from their insurance coverage. A reasonable amount of preparation and research will reduce anxiety related to responsibilities during the year ahead.
Here are some suggestions for helping your care recipient effectively access health services.
Getting Started: Tips for Maximizing Insurance Benefits This and Next Year
1. Stay Current on Preventive Care
Preventive care will help your care recipient maintain their health and possibly avoid more significant medical issues later on. Most insurance plans cover preventive care—vaccinations, screenings, and annual exams—at little to no cost. Make sure your care recipient takes full advantage of these services throughout the year so health risks are identified early.
2. Plan Procedure Timing Carefully
If your care recipient needs non-urgent procedures, schedule them thoughtfully. Some insurance plans reset deductibles at the beginning of the calendar year. This means it may make sense to schedule procedures toward the end of the year when your care recipient is more likely to have already met their deductible.
3. Look for Prescription Drug Discounts and Mail-Order Options
Many insurance plans offer discounts on prescription medications. Some have mail-order options for shipping medications at a lower cost. Check with your care recipient's insurer about switching to mail-order delivery for savings on prescription drugs.
4. Investigate Telehealth Benefits
Whether your care recipient is looking for routine check-ups or specialist visits, telehealth can save time and ease access to care. Assess your care recipient’s comfort level with technology and communicating virtually with medical professionals rather than in-person. Determine whether or not their insurance offers telehealth options, which may offer reduced copays and quicker appointment availability.
5. Don’t Forget to Use Flexible Spending Account (FSA) Benefits
An FSA is a special savings account that allows you to set aside pre-tax money to pay for select healthcare expenses. If your care recipient has an FSA, it’s important to remember that funds unused at year-end may be lost. FSAs can be utilized for many different medical expenses—from copays to over-the-counter medications to bandages and even sunscreen—so make sure your care recipient uses those funds before the deadline.
6. Consider a Health Savings Account (HSA)
Your care recipient’s insurance plan may qualify for an HSA, through which they could set aside pre-tax money for medical expenses. These funds can cover deductibles, copays, and other out-of-pocket costs. Unlike FSAs, HSA funds roll over from year to year and stay with your care recipient if they change jobs or retire.
7. Look for Discounted Chronic Disease and Wellness Programs
If your care recipient is managing a chronic condition like diabetes, asthma, or heart disease, some insurance plans provide specific disease management programs. These services might include regular check-ins and access to specialized care, often at a lower cost. Other insurance plans offer programs that provide rewards for healthy choices. Discounts are typically offered towards gym memberships and fitness trackers, or programs that encourage exercise, weight loss, and quitting smoking.
8. Review Your Plan’s Covered Services Regularly
Insurance plans can change from year to year, so it's important to regularly review what’s covered under your care recipient’s policy. Look into any new benefits or changes to existing coverage, such as lower copays for certain medications or expanded preventive care options. By staying familiar with policy updates, it’ll be easier to help your care recipient use available benefits to their fullest potential. (For more information, read our blog on questions to ask during Open Enrollment.)
9. Don’t Forget About Mental Health Resources
Many insurance plans cover mental health care such as counseling, therapy, and virtual services. If your care recipient needs support managing stress, anxiety, or other mental health challenges, explore their accessible benefit options. Some insurers also provide resources like employee assistance programs (EAPs) that offer a certain number of no-cost therapy sessions per year.
10. Use Benefits Before Year End
Unused benefits don’t roll over into the next calendar year. Encourage your care recipient to take full advantage of all covered services through, for example, scheduling an overdue annual checkup or filling prescriptions.
Looking Ahead
The end of the year is a busy and stressful time for everyone, particularly caregivers. With another holiday season on the horizon, it may feel like your to-do list is already a mile long and growing by the minute. Remember, you don’t need to act on all of these tips at once. Try one or two and set realistic expectations for following through. Any amount of effort will support your care recipient by maximizing their insurance benefits for the year.