Understand Your Insurance, Healthcare Deductible and Imaging
The end of the year is fast approaching, which means many people have hit their healthcare deductible for the year. If this describes you, it’s the perfect time to maximize your health insurance benefits and get medical care that you may have been putting off. This includes screening and diagnostic medical imaging scans, such as cancer screenings or imaging ordered by your doctor for specific problems.
Deductibles, premiums and copayments, explained
Your healthcare deductible is the amount you must pay for healthcare services before your insurance begins to pay. For example, if your deductible amount is $1,000, that is the amount you must pay out-of-pocket before your insurance company begins to pick up your medical expenses.
Your premium, the amount you pay monthly for your insurance coverage, doesn’t count toward your deductible. High deductible plans often have lower premiums, but may require you to pay more out-of-pocket costs up front.
Once you have met your annual deductible, your insurance company begins paying for covered expenses according to your plan. Keep in mind you may still have to pay a copayment, which is usually a fixed amount, or coinsurance, that you are responsible for paying. Each insurance plan is different and may require a fixed copay for visiting a specialist, such as an orthopedic surgeon, or urgent care copay. Some insurance plans have a copay amount after you reach the deductible spend. For example, an 80/20 plan means your insurance pays 80% of the bill and you pay 20% of the bill after you’ve met your deductible.
A copay amount is typically significantly less after you meet your deductible. It may be financially beneficial to get routine screenings and imaging for chronic health issues done at the end of the year if you have already met your deductible.
Have insurance? Some scans are free.
Through some health insurance plans, certain scans are fully covered, even before the deductible is met, with no cost to you. These may include:
- Mammograms
- Low-dose CT scan for lung cancer, depending on your coverage and whether or not you meet screening criteria
- Abdominal aortic aneurysm screening
Check with your health insurance provider to find out if your plan covers these or other preventive screenings.
Imaging center classifications and insurance coverage
Diagnostic imaging centers and services are primarily classified into one of four categories:
- Hospital: An acute care facility that may provide imaging services.
- Hospital-owned outpatient imaging: A dedicated imaging facility that is owned by the hospital and/or within a certain proximity of the acute care hospital.
- Independent diagnostic testing facility: A dedicated imaging facility independent of a physician’s office and a hospital.
- Physician-owned: The facility or imaging machine is owned and operated by a physician or physician practice.
The classification of the imaging center is a primary component in the cost of the imaging scan, followed by a contract agreement with an insurance provider on the amount a center may charge for an imaging scan.
Touchstone Medical Imaging centers are IDTF facilities resulting in up to 60% less costs than hospital-based imaging.
FSAs, HSAs and imaging studies
Flexible spending accounts (FSAs) and Health saving accounts (HSAs) are other ways to save on medical costs. If you have health insurance through your job, you may have the option to put money directly into an FSA or HSA before it is taxed. You can use this money to pay for certain out-of-pocket costs, such as prescription and some over-the-counter medications, medical supplies and devices, and deductibles and copayments, including those for imaging scans.
Early in the year, before you meet your healthcare deductible, you can use FSA or HSA money to pay your out-of-pocket costs for imaging. These costs will still count toward meeting your deductible.
If you have an FSA account, you will have a “use it or lose it” structure and must spend the funds by the end of the calendar year. Diagnostic imaging for answers to chronic health concerns could be a great way to use must-spend FSA dollars.
Get your diagnosis before your healthcare deductible resets
Take advantage of your health plan by getting your non-emergent diagnostic imaging done before the plan year resets at the beginning of next year. Touchstone Medical Imaging is in-network with 99% of health insurance plans and handles authorizations for medical imaging.
After getting a doctor’s order for a scan, visit the Touchstone Medical Imaging center most convenient for you.