Making the Most of Your Healthcare Dollars in 2025
9/5/2025
The last several months of the year are often spent enjoying cooler weather, watching football and preparing for the holidays. This is also a great time to review your health plan to determine whether you’ve met or are close to meeting your insurance deductible. If you have a flexible spending account (FSA), it’s time to check the balance for the remainder of the year.
Scheduling elective procedures and preventive screenings before the end of the year can help to maximize your healthcare dollars.
Most insurance plans require patients to pay more until they reach the amount of the deductible. When the deductible is met, the insurer begins paying a larger portion of the cost of services eligible through in-network providers. FSAs are typically “use-it-or-lose-it,” meaning funds have to be used for eligible healthcare expenses by the end of the year. These end of year deadlines make the second half of the year an opportune time to schedule medical procedures and screenings.
“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,” said Roy Boyd, chief financial officer (CFO) for Commonwealth 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.”
Private health insurance, including most Medicare Advantage plans, requires the beneficiary to cover most medical expenses until they reach their deductible. For example, someone who has a $2,000 deductible and a $4,000 out-of-pocket maximum is responsible for paying for medical expenses until they reach the $2,000 threshold. Once they pass this mark, the insurer begins paying a larger portion of the cost of services eligible through in-network providers. And when they reach the $4,000 out-of-pocket maximum, insurers usually will pay the total cost for eligible services.
Preventive health services – such as screening mammograms, colonoscopies and annual wellness visits – are often covered by insurance even when a deductible hasn’t been met. FSAs typically cover a broad range of services including screenings, diagnostic services and office visits.
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.
Now is the time to schedule an appointment to obtain medical services before the end of the year. Demand for services often increases in the second half of the year, and with surgeries, there may be preliminary tests and appointments needed before the procedure can be scheduled.
Whether you’re ready to schedule an elective procedure or just want to take care of annual screenings and visits, the patient access team at Commonwealth Health can help you understand your insurance coverage and what you can expect to pay for care. To talk with someone on the patient access team at:
Moses Taylor Hospital: (570) 770-5145 - PatAccEducation@mth.org
Regional Hospital of Scranton: (570) 770-3168 - PatAccEducation@mth.org
Wilkes-Barre General Hospital: (855) 890-3060 - PatAccEducation@commonwealthhealth.net
Back