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January 1st…We think of New Year’s resolutions and the end of the holiday season, but in the back of our minds, the dreaded reset of insurance deductibles. If you are like me, after doctor’s appointments, yearly check ups, and the occasional test, you might be lucky enough to meet your deductible. You then rush to get all appointments taken care of while insurance is covering the cost. Then the dreaded date of January 1st rolls around, and usually the first illness of the new year. January 1st comes, deductibles reset, and you once again start to see bills for medical appointments. Planning ahead can definitely help ease the burden of medical expenses.


What you can do to prepare:

1. Educate yourself on your insurance benefits. If you are like most people, insurance is hard to understand. Ask your doctors office, therapy office, or a friend to explain your insurance benefits in layman’s terms. The following website can also help you understand common terminology used in health insurance: Just being educated on your plan will help you know what may or may not be covered.

2. Prior to the start of the year, budget for the next year. Start an account that will cover your deductible for the new year. It is easy to plan ahead for yearly check-ups, however this will help you be prepared for the unforeseen doctor’s appointment or trip to the ER.

3. “Why have insurance if you still have to pay a deductible each year?” Having health insurance can lower your costs even when you have to pay out of pocket to meet your deductible. Insurance companies negotiate rates (for all medical services) with the providers’ offices. You are then charged the discounted rate. Individuals without insurance may pay double for the same service. You may find that certain services, tests, and/or procedures are more affordable if you know the adjusted rate.


4. Call your insurance company often to inquire about what they will cover for annual exams, sick visits, and any planned procedures. Do not just assume your insurance company will cover whatever you need. Always write down who you spoke with and when. This could help you if your insurance ever denies a service or claim.

5. Check with your employer or insurance agent every year to see if there are other plans available that will better fit you and/or your families needs. You may find signing up for a higher deductible/lower premium plan is cheaper in the long run, or you may find paying more for a lower deductible plan is better for your family.


Please talk with the front office employees at Pediatric Therapy Center if you need help understanding your insurance benefits for occupational, physical, and speech therapy. We are happy to help!

Sherry Landes
Office Manager

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