Schedule medical care now to use up year-end insurance benefits.

If you’ve paid a considerable portion of your yearly health insurance deductible, now is the time to start thinking about getting elective procedures done before the end of the year and the start of a new deductible period.

“Every year, we have patients who realize some time in late fall that they’ve nearly paid off their deductible, so they want to have the elective surgery we’ve discussed before the new annual deductible kicks in,” says J. Adair Prall, MD, a board-certified neurosurgeon and Senior Partner/CEO of Neurosurgery One, a private practice of Denver neurosurgeons and spine specialists. “We try our best to fit everyone in, but there are only so many surgical slots. And the list of patients wanting surgery is longer than usual now because so many surgeries were postponed during the pandemic.”

In August, Neurosurgery One saw the number of requests for appointments increase by more than 30% and that’s well before the typical fall seasonal increase in calls.

Before the end of the month, consumers should take the following actions:

• Review your annual individual and family health insurance deductibles to know how much you’ve already spent this year. (A deductible is the amount of money you have to pay out of pocket before your insurance benefits kick in.)
• Also review any health savings accounts, flexible spending accounts or health reimbursement accounts you have. Some accounts require you to spend any balances prior to the end of the year.
• Schedule appointments for routine care for the remainder of the year. Obtain referrals for specialty care and schedule those appointments.

Plan two weeks or longer for doctor’s appointments

If you want to be sure to get care before the end of the year, call your physician right away to schedule an appointment or get a referral to a specialist. Most physicians currently are running two to four weeks out for appointments. In addition, elective procedures often have required tests or other requirements you must complete before the procedure can be scheduled.

Here are some examples of needed time for common elective procedures for lower back pain or neck pain:

• Spinal Injections: 2-3 weeks for current patients, up to 6 weeks for new patients (including new patient evaluation appointment)
• Spinal Cord Stimulator: 6-8 weeks if necessary tests, such as an MRI and psychiatric evaluation have been completed. This time includes the required trial.
• Elective spine surgery: 4-5 weeks depending on availability of surgical time at hospital or ambulatory surgery center

Many patients don’t think of surgery as elective, so they don’t think about their out-of-pocket costs until they’ve made the decision to move forward and that’s when they’re often scrambling to get it completed before the end of the year, says David VanSickle, MD, a board-certified Denver neurosurgeon and medical director of the Denver DBS Center.

“Deciding to have deep brain stimulation is not a decision you make based on a calendar or using up your deductible,” Dr. VanSickle says. “But patients who have already been considering the procedure often are close to meeting their deductible by this point in the year and could get most of the costs covered.”

Four tips to get medical care faster

If you are trying to schedule appointments or treatment with a medical specialist, you can take steps to make the process smoother and faster. Neurosurgery One schedulers recommend these tips that apply to most medical practices:

1. Be willing to see the first provider available, including advanced practice providers such as physician assistants or nurse practitioners. They can get tests or imaging ordered, even if you ultimately have the procedure done by a different provider.
2. Get a referral from your primary care provider, if required by your insurance.
3. Be ready to provide the names and phone numbers of providers you’ve seen in the past when you call to schedule an appointment. Schedulers can then call those providers to get copies of your medical records prior to your appointment. Knowing what you’ve had done–or not done–can save valuable time and money.
4. Ask the scheduler if there are any tests or imaging that are needed prior to the appointment and ask your primary care provider to order those while you’re waiting to see the specialist.

If you would like to schedule an appointment with Neurosurgery One, please request an appointment online here.