Columbia News

As the year progresses, many people take time to review their health insurance plans and flexible spending accounts (FSAs) to maximize healthcare benefits before annual deadlines. The end of the year is commonly when individuals consider scheduling elective procedures and preventive screenings to make the most of their healthcare dollars.

Health insurance policies often require patients to pay for medical expenses until they reach a deductible. Once that deductible is met, insurers begin covering a larger share of costs for services provided by in-network providers. FSAs, which are usually “use-it-or-lose-it,” require funds to be spent on eligible healthcare expenses by year-end or risk forfeiture.

Rodney Sisk, Chief Financial Officer at Moberly Regional Medical Center (MRMC), explained: “Scheduling elective procedures – such as diagnostic tests or elective surgeries like joint replacement – in the same calendar year after a deductible has been met helps patients get the most value out of their health insurance plan, while taking care of their health. Utilizing remaining FSA funds can also help to cover any out-of-pocket costs and ensure you don’t forfeit dollars that you’ve already set aside for healthcare.”

For those with private health insurance or Medicare Advantage plans, initial medical expenses are paid out-of-pocket until deductibles are reached. For example, an individual with a $2,000 deductible and a $4,000 out-of-pocket maximum would be responsible for costs up to $2,000 before insurers increase coverage; after reaching $4,000 in total payments, insurers generally cover all eligible services.

Preventive services—such as screening mammograms, colonoscopies, and annual wellness visits—are often covered even if deductibles have not been met. FSAs typically reimburse a wide range of services including preventive screenings and office visits.

Erma Johnmeyer, family nurse practitioner at Moberly Rural Health Clinic emphasized the importance of routine care: “Even individuals who feel great should stay up to date on all recommended preventive health screenings to help identify any potential health issues or risk factors early. Early detection of many health issues such as high cholesterol or hypertension not only allows for more effective treatment, it can also reduce the need for more expensive treatments associated with advanced medical conditions.”

Patients are encouraged to schedule appointments soon due to increased demand later in the year. Surgeries may require preliminary tests and appointments before being scheduled.