Maximize health insurance benefits before year’s end

When it comes to health insurance, figuring out the right deductible, determining whether a provider is in or out of network, and budgeting for changing premiums are top of mind. But your health insurance plan likely includes other covered benefits and services you’re likely not aware of. According to a report from the Society for Human Resource Management, 53% of employed Americans say they don’t feel they’re getting the most from their health coverage; 54% say they don’t know the full scope of what’s offered in their plan.

Many insurance plans, specifically those offered through the Affordable Care Act, offer rewards programs. For example, an insurance carrier may offer a gift card for completing a wellness check-up or annual physical. In fact, a lot of plans will cover preventive care visits and screenings at 100%. These include cholesterol, blood pressure, diabetes and cancer screenings, as well as flu, shingles, RSV and HPV immunizations and COVID-19 boosters. So if it has been a while since you’ve had a physical, are entering the age for routine screenings or haven’t had time to get the vaccinations mentioned above, now is a good time to schedule those appointments.

Some health insurance plans, particularly those sponsored by employers, allow you to contribute to a health savings account or a flexible spending account.

An HSA is a tax-advantaged savings account that you can use to pay for qualified medical expenses. Any contributions you make are pretax or tax-deductible and the funds also grow tax-free. Any unused funds roll over into the next year. And since you own the account, it remains yours should you lose or change jobs. However, there are contribution limits you’ll want to be aware of. For 2025, the contribution limit for individuals is $4,150 and $8,300 for families. Those who are 55 and older are allowed to contribute a maximum of $1,000 in catch-up contributions.

FSAs are similar. Contributions made to these accounts are pretax, which will lower your taxable income. Withdrawals for eligible medical expenses are also tax free. However, the key difference between an FSA and an HSA is that most FSAs require you to spend funds by the plan’s year-end. In most cases, FSA holders are given a grace period after the plan year ends to use the old funds or are allowed to carry over a certain dollar amount, which is usually capped. This year, FSA holders can carry over $660 into 2026. It’s also important to note that FSAs are owned by the employer. So if you lose or change jobs, you’ll also lose the account.

Other perks that often get overlooked include telehealth and virtual mental health visits. Some plans may offer a lower copay for these visits or offer a certain number of visits at no cost.

Many health insurance plans also encourage health lifestyle choices by offering gym or fitness reimbursements, smoking cessation or weight management programs, and may even offer nutrition or health coaching. In many cases these additional perks are optional and may require you to enroll.

As for prescriptions, health insurance plans may offer mail-order prescriptions at a lower cost, drug comparison tools, medication adherence programs or manufacturer copay assistance.

Medicare Advantage offers additional benefits

For those receiving Medicare coverage, Medicare Advantage plans usually offer additional benefits not covered under original Medicare. This can include routine/comprehensive dental coverage, vision coverage, gym memberships and allowances for over-the-counter medications.

Consider reviewing your plan’s brochure or website to see if there are any additional services or perks that you can use before the end of the year. If you’ve already spent a lot on health care or have hit your plan’s maximum out-of-pocket for the year, prioritize getting any remaining medical care before the year ends while those services are covered. If you wait until the plan resets, you’ll be required to pay your portion until the deductible is met.

This time of year is busy and while it may not be at the top of your to-do list, checking to ensure you’re maximizing your health insurance coverage is a great way to cut down on out-of-pocket costs. You may find you’re paying for services your plan actually covers or offers at a reduced rate.

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Brandon Hill is a senior advisor at Beckett Financial Group. Contact him at [email protected].

[email protected]

Brandon Hill is a senior advisor at Beckett Financial Group. Contact him at [email protected].