If you think malls are a mob scene in December, try getting in to see your doctor.
You’ll join people trying to make the most of their insurance coverage, college kids home for the holidays and the first surge of winter flu patients.
This year the annual waiting-room crush is intensified by health insurance changes and an improving economy, some Charlotte medical offices say.
“It’s bad this year because a lot of employers changed their plans to higher deductibles,” says Colleen Dey, who works in finance at Carolinas Family Healthcare in Charlotte’s Ballantyne area. “We are having to turn away a lot of patients.”
High deductible plans, which a growing number of companies use to hold down costs, require patients to pay hundreds or even thousands of dollars out of pocket before their coverage kicks in. People who have met their 2014 deductible – or who are switching to a high-deductible plan for the first time in 2015 – are highly motivated to squeeze covered care into what’s left of this year.
Some of those workplace plans are accompanied by flexible spending accounts, which let employers and/or employees make pretax deposits to cover out-of-pocket costs. The catch? Some of that money can be lost if it’s not spent by year’s end.
That’s what sent Mac Sawyer hustling to see an orthopedic specialist about a “bum shoulder” that has troubled him for years. He and his wife realized they were facing the end of the year with $2,300 in their combined accounts. The IRS allows only $500 per account to be rolled over to the next year.
Sawyer, a senior business analyst for TIAA-CREF, says he managed to get a Dec. 19 consultation with a doctor. He’s just hoping that any costly tests can be squeezed in this month.
Meanwhile, he said, “we’re all attempting to get eyeglasses and anything else to chew away at it.”
Dr. James Appel, a Charlotte plastic surgeon, has extended his office hours and surgical schedule to handle the year-end rush, which he says started earlier than usual this year.
Some patients are seeking nonurgent procedures, such as removal of skin lesions or keloid scars, while they can get insurance reimbursement. Others are lining up for cosmetic procedures that aren’t covered, he said. For those patients, the year-end enticement may be time off to recover, he said, while an improving economy seems to be stimulating demand.
Appel said his office tries to “bend over backward” to work people in, but “there comes a time when you don’t have any available space.”
The staff at Carolinas Family Healthcare reports the same dilemma. They’re facing everything from an early surge of sick patients to people trying to squeeze in costly treatments for chronic conditions. Many are even pushing to work in checkups, which most policies fully cover regardless of deductibles. But accompanying lab work and discussion of specific medical problems can bring fees.
In early December, Dey said, one woman called seeking wellness exams for five members of her family – and wanted them all on the same day before year’s end.
Dey and her colleagues say they understand the urgency when hundreds of dollars are at stake. But requests such as that just aren’t practical.
Adding to this year’s crush is the fact that the 2014 debut of the Affordable Care Act exchange brought hundreds of thousands of Carolinians into the insurance market.
For some patients, plain old procrastination factors in. When a reporter asked Robin Baltimore, a spokeswoman for Novant Health, about the year-end rush to get appointments, she remembered that Novant rewards healthy behavior by putting extra money into employees’ health reimbursement accounts if they get a checkup each year. With about three weeks left in 2014, she hadn’t done so.
“I must schedule my appointment soon or I lose $150,” she said.
Good luck with that. Because it’s not only patients who have time off at the holidays. Doctors and their staff plan to spend some time with their families, too.