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health insurance year-round

Accidents and injuries always seem to come at the worst time. There’s also never a good time to deal with health insurance deductibles and copays. However, with a bit of careful planning throughout the year, you can get the most out of your health insurance year-round, and make these unfortunate illnesses and accidents less difficult.

How to Get the Most Out of Your Health Insurance Year-Round

To get the most out of your health insurance year-round, it’s important to know how billing works. Your deductible—the amount you must pay before your insurance starts paying—and your out-of-pocket maximum—the most you will have to pay for services—reset each year. This means it will generally be more expensive to get care in the beginning of the year before your deductible is met, and less expensive later on.

If you can anticipate the care you or your family will need throughout the year, you can avoid using payment plans or getting behind and paying interest. Also, using preventative care measures will help you avoid bigger problems. To get the most out of your health insurance year-round, be ready for these events each season. It’s impossible to know for sure when or if accidents or injuries will occur, but it’s important to know when the risk is higher.

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Winter: Cold, Flu and Planning

Though Florida experiences some of the warmest winters in the country, the weather is still colder than usual. In general, wintertime means we stay inside more, get less sun (and vitamin D), and exercise less. Due to the holidays, we may also feel more stressed and eat more junk food. Cold, dry air in winter also makes it easier for airborne pathogens to stay in the air, and allows them to multiply faster. All of this means you’re more likely to get sick with either the cold or flu.

  • Flu shots: To get the most out of your health insurance in winter, take advantage of flu shots. Medicare, Medicaid and all private insurance are required to cover the cost of flu shots. However, some insurances only cover flu vaccinations from doctors, so pharmacy flu shots won’t be covered. 
  • Stress management: Under the Mental Health Parity Law, most health insurance providers must cover mental health services and physical health services in similar ways. Winter and the holidays are filled with stress, which can wreak havoc on our health. If you start to feel overwhelmed, anxious, you can’t sleep, or you’re feeling depressed and you don’t have energy, practice self-care and make an appointment with a therapist in your insurance network. 
  • Planning and Budgeting: To get the most out of your health insurance, it’s best to plan expected appointments at the beginning of the year. If you schedule appointments, surgeries, chiropractic care and other services at the beginning of the year, you’ll fill your deductible sooner and you’ll pay less for any unexpected services later on.  

Spring: Car Accidents and Sports 

As the weather warms, more Floridians get outdoors again. While more sun, exercise and a better mood improve your health, there are, of course, other risks. Adults and kids are just getting back into their favorite sports and pastimes, and this makes injuries more common as players get back into shape and rediscover their technique. In March, spring break is also the riskiest time to be on the road as drunk driving and traffic congestion in general both sky-rocket.

  • Sports physicals: Many school sports require physicals for kids to participate, and it’s a good idea for adults too. However, annual wellness checks are covered by insurance and will detect health issues a physical won’t. To get the most out of your health insurance, schedule a full health check instead of a sports physical. 
  • Sports injuries: Tennis elbow, shin splints, knee injuries, ankles sprains and more affect both kids and adults. Keep some money in your Health Savings Account or Flexible Spending Account for these injuries. Never let these injuries go untreated; they will only get worse. 
  • Spring break: Americans flock to Florida during spring break, dramatically increasing traffic on the road. Spring break partiers also increase dangerous drunk driving, one of the leading causes of car accidents in Florida. Review your PIP insurance and health insurance so you know what is covered under what plan. Practice extra caution while driving during this time. 

Summer: Road Dangers and Hurricanes

With warm temperatures and plenty of beaches, summer is the favorite season for many Floridians. With lots of exercise, sunshine, fruits and vegetables, it’s also a usually healthy period for most. June marks the start of hurricane season, however, which can bring hazardous roads and car accidents. Heat stroke and sports injuries are also on the list of risks.

  • Hurricanes: Hurricanes and tropical storms bring heavy winds and rainfall, which means car accidents. Again, make sure you understand how your PIP coverage and health coverage interact. If you are injured in an accident, don’t wait to get treatment. If you have a back or neck injury, work with a chiropractor to prevent long-term pain and regain full mobility. 
  • Sports injuries: Summer is a great time for tennis, soccer, golf, jogging and much more. This also increases the risk of sports injuries. If you have an injury that makes it difficult to play, make an appointment so the injury doesn’t get worse. 
  • Planning: Since June is mid-way through the year, it’s a good time to reassess your individual and family deductibles and out-of-pocket maximums. Are you close to meeting these amounts? Do you still need more care? Block out some time to see where you stand. 

Fall: Have You Met Your Deductible?

As the leaves start to change, we all know that the year is coming to a close. If you’ve met your deductible and especially if you’ve met your out-of-pocket maximum, now might be your last chance of the year to schedule any appointments you’ve been putting off. It’s ideal to get these out of the way before the holidays, so you have time to recover. If you need any of the following, the fall is a good time to schedule these.

  • Surgery: Many types of surgery are not immediately required, but are necessary and covered by health insurance. If you met your deductible and out-of-pocket maximum earlier in the year, now is a good time to schedule these. These might include knee surgery, cataract surgery, weight loss surgery, or Lasik eye surgery. 
  • Therapy: Seasonal affective disorder affects millions, and it often starts when temperatures dip and days get shorter. If you start to feel depressed, schedule a therapy appointment to make later months easier. 
  • Massage and physical therapy: If you had an accident or injury earlier in the year and you still have pain or a lack of mobility, don’t put off treatment any longer. Massage, chiropractic services, physical therapy and other therapies may be covered by your insurance and can help you feel better. 

No matter what appointments or health care need you have, always communicate openly with your doctor so you know what you are billed for. Double-check your insurance documents to make sure you know what is covered and that you are billed accurately. When you are prepared for the worst, you won’t be caught off-guard and you’ll be able to get the most out of your health insurance every month.


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