4-minute read

In health insurance lingo, “seasonality” refers to the predictable spending patterns that occur at specific times of the year. In this case, we’re talking about the continual increase in healthcare spending as the plan year progresses.

This happens because almost all health insurance plans have a deductible — the amount of money a person has to spend out of pocket before their insurance benefits really kick in — that resets at the beginning of the plan year.

Many people will put off non-emergency medical care until their yearly deductible has been met in an attempt to save money. In doing so, their healthcare spending tends to increase as the plan year rolls on.

We refer to this group as “late spenders.” What’s interesting is that in many cases, the late spender would have met their deductible earlier had they simply received the care they needed at the time it became apparent there was a medical issue.

Let’s say you have a $5,000 deductible. You might spread this cost over several months — skipping care in hope of saving money in the long run — before eventually meeting your deductible and your insurance starts contributing more toward the overall cost of care at the end of the year.

Alternatively, you could have received the care you needed, at the time you needed it, and met your $5,000 deductible in February — and then insurance would’ve taken over for the rest of the year. We refer to patients who exhibit this type of behavior as “early spenders.”

But here’s the catch: While our late spender and our early spender take dramatically different approaches, both patients spend the same $5,000 over the course of the year. So ultimately, delaying care until deductibles are met has little to no effect on the total amount spent. This begs one key question: What are the consequences of this behavior?

Here’s an example of a situation that could result from delaying care. A 56-year-old man has been experiencing some mild, intermittent chest pain. It’s been bothering him for a few weeks and is getting worse. But it happens mostly when he exercises, and seems to improve after a few minutes of rest, (Plus, he hasn’t met his deductible yet and is concerned about the upfront costs) so he decides to ignore the pain.

Over time, what started as a minor irritation escalates into frequent and severe episodes. Now experiencing pain in regular intervals, the patient finally decides to see his primary care provider.

After a brief consultation, his doctor sent him straight to the hospital for a stress test. A few hours later, the cardiologist called the doctor back with an update: “Your patient had an abnormal stress test, so we checked out the arteries in his heart. He has a major blockage. He’s getting surgery in the morning. Thanks for sending him over — he might have died if you hadn’t.”

The delay in seeking care not only put the patient at risk of a major cardiac event — which was life-threatening — but also led to more complex and costly medical intervention.

Of course, not every patient has such a dramatic story. But delaying care is a common practice, and can lead even the simplest scenarios to turn serious.

In just about every case, early care leads to better outcomes. When people put off the care they need because of financial concerns, they may still end up spending the same amount of money by the end of the year. So, while the financial differences might be negligible, the health outcomes can easily be much worse. It’s important to keep that in mind as you attempt to manage spending along your health journey.

Paytient offers a flexible way to manage healthcare expenses, and can help you cover out-of-pocket costs before you’ve met your deductible.* This means you can get the care you need when you need it, without the financial strain. So, instead of waiting until your deductible is met, let Paytient assist you in prioritizing your health now, for both peace of mind and better health outcomes.

*Paytient is an employer- or health plan-sponsored benefit subject to approval, and spending categories vary. Check your eligibility at Paytient.com/welcome.

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