Dodging Deductibles

Make the most of your insurance before the new year.

Most people with health insurance have a deductible. That’s the amount people must pay for covered services before their insurance plan starts to pay. The deductible is generally assessed at the beginning of each plan year, often in January. To make the most of their insurance benefits, people try to have their routine health services
completed by the end of their plan year.

Photo by Nerissa Johnson.

Cathryn “Kim” Fellinger

“Once people meet their deductibles, their insurance generally pays a percentage of covered services,” informs Barbara Borden, center director at LAD imaging, a fully accredited, outpatient imaging center in Deltona. “If people need services, the end of the year is a good time to get them because they’ve got their deductibles again at the first of the year.
“In addition, some people have health reimbursement arrangements [HRAs] with their employers. An HRA is an employer-funded benefit that reimburses employees for out-of-pocket health expenses. Others have flexible spending accounts where employees contribute money from their salaries to go toward deductibles. These accounts also run on a yearly basis.”
It makes good financial sense for people to get all of their health needs addressed before a new deductible is assessed. However, Barbara encourages them to schedule their appointments throughout the year instead of waiting until the last few months. She suggests they begin the process as soon as their current deductibles are met.
“There can be problems when everybody waits to get their services at the end of the year,” she notes. “Schedules get busy. Physicians get busy. Patients are competing with many others for appointment times. Sometimes, because they waited, patients have trouble getting appointments and get kicked into the new year and a new deductible.
“Getting things done when people want to do them can be difficult; I know how life is. Family, work and other factors get in the way, but patients need to make plans for themselves and their families. They need to take the time to get the services done that they’ve been postponing, before the end of the year.”
At LAD imaging, the staff wants to help its patients get the most of their insurance, so they make an effort to accommodate everyone who needs imaging services any time of year. They’re open on Saturdays and offer extended hours, with morning and evening appointments, during the week to accommodate those who work. For some exams, walk-in service is also available.

Christmas in June

Before retiring on 11/11/11, Cathryn “Kim” Fellinger lobbied for state employee issues before the legislature of the State of Ohio, from which she is a native. Upon retirement, she relocated to Florida and soon began looking for a local, free-standing imaging center. She found one through the West Volusia Regional Chamber of Commerce.
“At a Chamber of Commerce event, I met Diane, a representative of LAD imaging,” Kim relates. “I discovered that LAD imaging is close to where I live, easy to get to and easy to get into and out of. Those are things I think about now that I didn’t think about when I was younger. Everybody at LAD imaging is friendly.”
Kim is an active participant in her health care. She’s faithful about getting her routine screenings, such as mammograms. She also suffers from scoliosis and has regular MRIs to check the progression of the curvature in her spine. She counts on LAD imaging to provide these tests, and Kim tries to get them done by the end of her insurance plan year.
“My insurance actually runs differently than most,” she describes. “It’s not a calendar-year benefit program; mine runs from July first to June thirtieth. It’s different for me to deal with providers because they’re used to people doing everything toward the end of the calendar year.
“Insurance works best for me if I get as many of the services I know I need done early and meet my deductible, so most of what I need done during the rest of the plan year is covered.
“On one hand, it’s generally easier for me to get appointments during the year because I’m not going head-to-head with the crush of people who wait until the last minute to use their benefits. I actually have a bit of an advantage.
“On the other hand, it’s harder for me to get in at the end of the year, not because of my insurance, but because of everybody else’s. If it’s December and I need something done, I have to make sure I have enough lead time because everyone else is trying to get in for their own reasons. I know I have to book an appointment way ahead of time.”

“If people need services, the end of the year is a good time to get them because they’ve got their deductibles again at the first of the year.” -Barbara

Even though Kim is typically not having services performed at the end of the calendar year, she sometimes finds herself at the end of her insurance plan year needing to schedule imaging exams or other services.
“I tend to do what everybody else does,” she admits. “My benefit year ends in June, and I try to get services in before the end of the year. One time, I tried to get my MRI done before the end of June, but it wasn’t ordered until June, and it just didn’t happen for a variety of reasons.
“So, I do the same thing. The timing just looks different. I don’t have the crunch everybody has in December.”

Ongoing Education

LAD imaging serves the community with a wide range of diagnostic imaging tests. These include traditional x-rays, computed tomography (CT), mammography, DEXA scans (bone density), high-field MRI and magnetic resonance angiography (MRA), ultrasound (including four-dimensional OB images) and vascular studies.
“No matter what imaging exam the patients require, when they come to LAD imaging, each scheduled procedure is thoroughly explained to them before the test is started,” assures Barbara. “This gives patients a better understanding of how the images are being acquired, how they will be used and what they can show.
“We also strive to educate the medical community about the advanced procedures we can perform here and how we can expedite referring physicians’ results if one of our radiologists notices something suspicious. In that way, physicians are able to move quickly toward helping their patients receive the appropriate treatment.”
Providing quality patient care is LAD imaging’s top priority, stresses Barbara. The center is fully accredited by the American College of Radiology®, and it participates in most insurance plans, including Medicare and Medicaid.

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