Don’t leave valuable healthcare benefits on the table as the year comes to a close.

As December approaches, it’s time to think about more than just holiday plans. For patients managing arthritis or osteoporosis, the end of the year is crucial for maximizing healthcare benefits before they reset on January 1st. 

Understanding Year-End Insurance

Most insurance deductibles reset to zero on January 1st. If you’ve already met your deductible, services before December 31st may cost significantly less than in January. Additionally, FSA funds are typically “use it or lose it,” with most expiring on December 31st. 

Your Essential Year-End Checklist

  • Check Your Deductible Status: Log into your insurance portal to see how much of your deductible you’ve met. If you’re close to your out-of-pocket maximum, schedule any procedures or tests you’ve been postponing before year-end.
  • Schedule Your Bone Density Test: If it’s been 1-2 years since your last DEXA scan, schedule it now. This uses current-year benefits and helps your doctor adjust treatment plans before the new year.
  • Refill Your Medications: Get 90-day supplies of all medications before December 31st. Insurance formularies often change on January 1st, potentially requiring new prior authorizations or increasing co-pays. This is especially important for expensive biologics and specialty medications. 
  • Complete Preventive Care: Schedule your annual physical, flu shot, and any overdue screenings. Most insurance covers preventive care at 100% with no out-of-pocket cost. 
  • Use Your FSA Funds: Check your FSA balance and purchase eligible items like heating pads, compression gloves, pain relief products, or supplements (with documentation). Don’t lose this money. 
  • Schedule Your Rheumatology Appointment: Book a year-end check-up to assess treatment effectiveness, order necessary labs while using current-year benefits, and renew medication prior authorizations before they expire. 
  • Get Lab Work Done: Complete any ordered lab work (inflammatory markers, medication monitoring, bone health markers) before year-end to use current deductible contributions. 
  • Renew Prior Authorizations: Contact your doctor’s office to renew authorizations for biologics and specialty medications. This process takes 2-4 weeks, so start early to prevent gaps in coverage. 
  • Schedule Imaging or Procedures: If your doctor recommended imaging or procedures, schedule them before year-end if you’ve met your deductible. The same procedure could cost hundreds or thousands more in January. 
  • Verify Next Year’s Coverage: Review new insurance documents to confirm your doctors are still in-network, your medications are still covered, and understand any changes to co-pays or deductibles.

Action Timeline

  • Early December: Review insurance status, check FSA balance, and medications.
  • Early December: Schedule appointments, request medication renewals, and start prior authorizations.
  • Mid-December: Complete appointments, get labs done, pick up prescriptions.
  • Before December 31st: Use FSA funds, verify all prescriptions filled, and confirm January appointments. 

Common Mistakes to Avoid

Don’t wait until the last week of December when offices are busy, and staff are on vacation. Don’t assume last year’s coverage continues and always verify. Don’t forget that prior authorizations take 2-4 weeks, so start early. 

We’re Here to Help

At Overlake Arthritis and Osteoporosis Center, we’re here to help you navigate year-end healthcare tasks. Contact us to schedule appointments, discuss your treatment plan, or request medication refills.

📞 Call us at (425) 453-0766 📧 Email us at psr@overlakearthritis.com

Let’s close out this year strong and set you up for a healthy new year.

Take the next step: At Overlake Arthritis and Osteoporosis Center, our mission is to help people with arthritic joint pain find relief and those with autoimmune diseases regain control of their health. If you’re in the greater Seattle area, email us at psr@overlakearthritis.com or 📞 call us at (425) 453-0766.  Your path to relief starts here! Don’t wait—contact us today!