Every December, our Logan office gets a wave of calls from people who suddenly realize their health benefits are about to reset. Some have met their deductible after a year of appointments. Others have money sitting in a flexible spending account that will disappear if they do not use it. Many have been putting off care for a nagging back or neck problem and now see a reason to finally deal with it.
If that sounds like you, now is a good time to look at your benefits. This guide explains how year-end timing works, what to check with your plan, and how to make the most of what you have already paid for.
Key Takeaways
- Most health plans reset deductibles and visit limits on January 1, so care before December 31 may cost less if you have already met your deductible.
- FSA money generally must be used within the plan year, though some employers offer a short grace period or a limited carryover.
- The IRS lists chiropractic fees as a qualifying medical expense, which is why many HSA and FSA plans cover chiropractic care.
- Coverage varies widely by plan. Our staff will verify and explain your benefits before treatment at no charge.
- Starting care in November gives you time to complete a short course of treatment before the year ends.
Why the End of the Year Matters
Health insurance runs on an annual cycle. Your deductible, out-of-pocket maximum and any limit on chiropractic visits usually start over at the beginning of each plan year, which for most people is January 1.
Your Deductible Resets
A deductible is the amount you pay for covered services before your insurance starts to pay. If you have already met it this year, covered chiropractic care in November and December may cost you much less than the same care in January, when the count starts again.
Your Out-of-Pocket Maximum Resets Too
If you have had a costly year, such as surgery, a new baby or an injury, you may have reached your out-of-pocket maximum. Once you reach it, your plan typically pays for covered services at 100 percent for the rest of the plan year.
Visit Limits Start Over
Many plans cap chiropractic visits per year. If you have visits left, they usually expire on December 31.
Using Your FSA or HSA for Chiropractic Care
Is Chiropractic Care an Eligible Expense?
IRS Publication 502 states that you can include fees you pay to a chiropractor for medical care in your medical expenses. Because HSAs and FSAs generally follow these IRS rules, chiropractic care is commonly an eligible expense. Your specific plan administrator has the final say, so confirm before you book.
FSA: Use It or Lose It
A flexible spending account is funded from your paycheck before taxes, and the money generally must be used within the plan year. According to HealthCare.gov, employers may offer either a grace period of up to two and a half months or a limited carryover into the next year, but not both. Any remaining money after that is lost. Check your balance and your employer’s rules now.
HSA: No Deadline, Still Useful
A health savings account works with high-deductible plans, and the money rolls over from year to year. There is no year-end deadline, but HSA funds remain a pre-tax way to pay for care, which matters if your deductible resets in January. It can also pay for eligible care for your spouse and dependents.
What About Medicare?
Cache Chiro accepts Medicare. According to Medicare.gov, Medicare Part B only covers manual adjustments of the spine by a chiropractor to correct a subluxation, a spinal joint that is not moving properly. Other services and examinations may not be covered. Part B also has an annual deductible, so the same year-end timing can apply. Our team will explain what is and is not covered before you start.
Auto Accident and Workers’ Compensation Claims
Year-end timing works differently for injuries. If you were hurt in a car accident, care is usually billed to auto insurance rather than your health plan, and for most auto accident patients it is covered at 100 percent. Do not wait for the new year; early care and documentation matter. Our accident injury treatment page and our article on delayed whiplash symptoms explain why. We also accept workers’ compensation for on-the-job injuries.
How to Make the Most of Your Remaining Benefits
Step 1: Check Your Numbers
Log in to your insurance portal or call your plan. Note how much of your deductible you have met, your out-of-pocket maximum, any remaining chiropractic visits, and your FSA balance. Write these numbers down before you call our office.
Step 2: Call Us to Verify Coverage
Our office participates in most insurance programs, and our staff will verify and explain your benefits before treatment at no charge. You can review the details on our payment options page.
Step 3: Book Early
The weeks before the holidays fill quickly, and many people try to squeeze in care in the last few days of December. Starting in November gives you time for an evaluation and a short course of care. Our article on how much a chiropractor costs in Logan explains typical costs in more detail.
Step 4: Fill Out Forms Ahead of Time
Completing your new patient forms before your visit saves time and gets you into treatment faster.
What Care Might Look Like Before Year-End
Your plan depends on what we find. A recent strain may need only a few visits, while longer-standing problems may start with Phase 1 relief care and continue into Phase 2 corrective care. Care may include spinal manipulation and adjustments, myofascial release and stretching and strengthening.
We will never stretch a care plan to use up your benefits. You will receive an honest recommendation based on your condition, and if you need only two visits, that is what we will recommend. If you are new to chiropractic, our articles on what happens during an adjustment and whether chiropractic is safe answer common first-time questions.
Problems Worth Addressing Before the New Year
If you have been living with any of these, year-end is a practical time to get them checked:
- Ongoing back pain that flares with sitting, lifting or sleeping
- Neck pain and stiffness, especially with headaches
- Pain that travels down the leg, such as sciatica
- Joint pain in the shoulders, hips or knees that makes daily activities harder
Problems like these rarely improve on their own while you wait for January, and winter activities such as shoveling snow often make them worse. Getting evaluated now means you start the new year with a clear plan instead of a lingering ache.
No Insurance or Limited Coverage?
You still have options. Many of our patients pay directly because they find chiropractic care cost-effective, and flexible payment programs can be arranged for patients with little or no chiropractic coverage. First-time patients should also ask about our new patient special offer.
Frequently Asked Questions
Can I use my FSA for a chiropractor?
In most cases, yes. The IRS lists chiropractic fees as a qualifying medical expense, but confirm with your FSA administrator because plan rules vary.
Does health insurance cover chiropractic care?
Many plans do, often with visit limits or copays. Coverage varies, so our staff will verify your benefits before treatment.
What happens to my deductible on January 1?
For most plans, the deductible resets to zero at the start of the new plan year, so you begin paying toward it again.
Does Medicare cover chiropractic care?
Medicare Part B covers manual spinal adjustments to correct a subluxation. Other chiropractic services and exams may not be covered.
Can I start care in December and continue in January?
Yes. Your care plan is based on your condition, not the calendar. Visits in January simply count toward your new plan year.
What if I have money left in my FSA after December?
Your employer may offer a grace period or a limited carryover. Otherwise, unused funds are lost.
The Bottom Line
If you have met your deductible, have visits left, or have FSA money that will expire, the end of the year is a smart time to take care of the back or neck pain you have been putting off. Check your numbers, call early, and let us verify your coverage.
Book an appointment or contact Cache Chiro at (435) 753-2840 to check your benefits and schedule before the holiday rush. Dr. Misustin and our team will make sure you know what your care will cost before it starts. Learn what to expect on your first visit.
Cache Chiro | 1415 N 400 E Ste A, Logan, UT 84341
Open Monday through Thursday, 8:00 AM to 12:30 PM and 2:30 PM to 5:30 PM. Serving Logan, Smithfield, Providence, Hyrum and all of Cache Valley.