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I’m sorry, my deductible did WHAT?

By January 9, 2020May 20th, 2021Insurance

We have entered that time of year when people experience this scenario:

The patient walks to the front counter to pay for a doctor visit and is told, “since the extra test we ran today goes toward your deductible, and we show that you have not met any of your $5,000 deductible, that will be $273.45, Mr. Jones”

[[Insert panic face of Mr. Jones]]

“Whoa, whoa, there has been some mistake, I know I paid my deductible AND max out-of-pocket already!”

“No, sir, I called to verify your benefits and was informed that your deductible reset.”

“My deductible did what?”

“Reset, sir. You have to pay your entire $5,000 deductible again”

“This is complete Bull S&$@!” as he hands over his credit card shaking his head in disbelief.


No matter when your plan renews (you know, the effective date listed on your ID card), your deductible and max out of pocket amounts for the majority of insurance plans reset (or “start over”) January 1st every year, even if you change to a different insurance provider.

Here are 2 helpful tips:

✔ If you change providers in the middle of the year, DON’T LOOSE WHAT YOU HAVE ALREADY PAID!

    • Ask the old provider (call or log into your employee portal) for your year-to-date deductible and max out of pocket amounts.
    • Ask the new provider for a deductible/max out of pocket credit form (sometimes called a deductible roll over form).
    • Send the form along with your current paid to date amounts to your new carrier.
    • And “voila” what you have paid for that calendar year is now on your new plan!

✔ If you have not paid anything toward your deductible or max out of pocket (and/or it’s January and you are starting over), and you need to have a procedure/test done, you DO have the option to SHOP FOR SERVICES!

✔ [I’ll say that again in case you read over my yelling font]! Y’all, if a doctor or facility says you need a test or procedure done, you DON’T have to go to the place they recommend, YOU can shop around to make sure you are getting a fair price, even if you pay the dang cash price! They don’t say “cash is king” for nothing.

What this all boils down to is:

☛ Continue to pay more than is necessary or ASK SOME DANG QUESTIONS!

☛ Nothing changes until you do, come on, y’all, take control!  IT JUST AIN’T THAT DANG COMPLICATED!


#insurance #Highpoint #HighpointInsurance #Itaintthatcomplicated #deductible

Erika Ensign, Risk Architect-Employee Benefits
Highpoint Insurance Group