What To Do When You've Met Your Deductible

As we prepare for next year, it is time to start enrolling in an insurance plan to ensure you have healthcare coverage! While you are looking over the best type of insurance coverage for you and your family for the new year, don’t forget to check to see if you have met your deductible in the current year and get some help for those work from home aches and pains you’ve been experiencing before your benefits rollover.

The 101 on Deductibles

A deductible is the amount you pay for health and medical services before your insurer covers anything. For example, if you have a $1,000 deductible, that means that you have to pay $1,000 on health and medical services out of your own pocket before insurance kicks in. Once you have met your deductible, insurance will start to cover a large portion of your health care costs and you will pay a copay (the remaining cost that the insurance doesn’t cover).

Medical co-insurance is a cost-sharing arrangement between you and your health insurance company. After you meet your annual deductible, you pay a percentage of your medical bills, while your insurer covers the rest. For example, if your co-insurance is 20%, you pay 20% of the costs, and your insurer pays 80%. Once someone has met their out-of-pocket limit, the insurance will pay the rest of the covered health services for the remainder of the year.

What if I have a Flexible Spending Account (FSA) or Health Savings Account (HSA)?

Both FSA and HSA accounts are like your own personal savings account for any medical expenses but they have some important stipulations. Both contribute pre-tax dollars (that each employee determines), lowering their taxable income that they can use for any out-of-pocket medical expenses, such as copays, qualifying prescriptions, and certain medical equipment.

HSA is an employee-owned account that rolls over annually and they can continue to accrue funds. An FSA expires at the end of the year and may also have limited availability for covered items compared to HSAs.

Early Intervention with Physical Therapy

You don’t have to deal with physical, day-to-day pain in your life. The good news is both accounts can be used to help cover physical therapy services — which can actually result in even more savings!

Early intervention with physical therapy when you notice that you’re dealing with a chronic injury or chronic pain can help you save thousands of dollars in the long run and help you save a bit more money in your wallet as well.

An individual who directly consults and is treated by a physical therapist can save a significant amount of time and money when undergoing treatment. In direct access states especially, there are a lot of opportunities to connect initially with a physical therapist near you and avoid doctor’s visits, or unnecessary tests or more invasive procedures.

By seeing a physical therapist first, you can also avoid unnecessary co-pays and time spent in a waiting room. This means that not only can you save money in the long run, you can also significantly cut down on the time it takes for you to get meaningful progress done when it comes to alleviating your pain and working to prevent future pain and injuries.

Direct access states mean that you have the ability to schedule an appointment with a licensed physical therapist near you and start seeking that care you need much faster without spending time or money trying to book appointments for a referral or physician weeks in advance when you can just as easily connect with a physical therapist faster.

Most importantly, with early physical therapy intervention, you can get to the root of your musculoskeletal issues and receive personalized treatment specific to you, your goals, and your injuries.

There are plenty of benefits associated with taking advantage of direct access with a licensed physical therapist if you happen to live in one of the many states that now provide direct access for your physical therapy needs.

Our team of physical therapists go above and beyond to educate our patients on how their injuries occur and highlight the steps to take to ensure the same issue doesn’t happen again. We combine our specialty hands-on approach, or manual therapy, with education and a personalized exercise treatment plan to create the most positive outcome possible for our patients. Musculoskeletal disorders are not inevitable, and with the proper support of a professional, these musculoskeletal disorders are preventable!

Schedule an appointment today with a licensed physical therapist near you in one of our hundreds of clinics across the country or connect virtually with our new virtual therapy telehealth option.

1. “You’ve Met Your Deductible: Which Medical Services Should You Have Before Year’s End?” Stormont Vail Health, 27 Oct. 2020, www.stormontvail.org/2018/11/13/meeting-your-deductible/.
2. “HSA vs. FSA What’s the Difference?: Quick Reference Chart.” Patriot Software, 3 Mar. 2021, www.patriotsoftware.com/blog/payroll/fsa-vs-hsa-what-s-the-difference/#:~:text=Flexible%20spending%20accounts%20(FSAs)%20and,account%2C%20lowering%20their%20taxable%20income.