Why December is the Most Financially Strategic Time to Seek Help
As the year draws to a close, our minds turn to holidays, family, and plans for the New Year. But there is another critical deadline approaching on December 31st: the reset of your health insurance benefits. For individuals struggling with addiction or mental health issues, understanding your insurance policy’s timeline can be the difference between affordable, accessible care and a significant financial burden. The concept is simple: use it or lose it.
At Serenity at Summit, we want to help you make the smartest possible decision for your health and your wallet. If you have been considering treatment for yourself or a loved one, there is a compelling financial reason to act now rather than waiting for January 1st. Let’s break down how end-of-year insurance benefits work and why maximizing them can make world-class treatment more attainable than ever.
The “Deductible” Advantage
Most health insurance plans operate on a calendar year. This means that every January 1st, your deductible resets. The deductible is the amount of money you must pay out-of-pocket for healthcare services before your insurance company starts to pay its share.
By December, many people have already met their deductible for the year through routine doctor’s visits, prescriptions, or other medical needs.
- Scenario A (Waiting until January): You enter treatment on January 5th. Your deductible has reset. You may have to pay the first $2,000, $5,000, or even more out-of-pocket before your coverage kicks in.
- Scenario B (Acting Now): You enter treatment in December. You have already met your deductible for 2025. Your insurance coverage kicks in immediately or at a much higher percentage. You could save thousands of dollars simply by starting treatment three weeks earlier.
The “Out-of-Pocket Maximum” Gold Mine
Even better than meeting your deductible is meeting your Out-of-Pocket Maximum. This is the absolute cap on what you have to pay for covered services in a year. Once you hit this number, your insurance company typically pays 100% of all covered costs for the rest of the year.
If you or your family have incurred significant medical expenses in the past year, you may have already reached this cap. This means that a comprehensive residential treatment stay at Serenity at Summit—including detox, therapy, and housing—could potentially cost you $0 out of pocket. This is a rare window of opportunity that closes the moment the ball drops on New Year’s Eve.
Don’t Forget Your FSA and HSA
Many employees contribute to Flexible Spending Accounts (FSA) or Health Savings Accounts (HSA).
- FSA (Use It or Lose It): FSA funds often expire at the end of the year. If you have money left in this account, you can use it to pay for addiction treatment, co-pays, or therapy. If you don’t use it, that money disappears.
- HSA (Rolls Over, But Strategic): HSA funds roll over, but using them now to cover any remaining costs for treatment is a tax-advantaged way to invest in your health.
Beating the “New Year, New Me” Rush
Beyond the financial benefits, there is a logistical advantage to seeking treatment in December. January is historically the busiest month for rehab admissions. The “New Year’s Resolution” mindset leads to a surge in calls, which can result in waitlists and limited availability for beds.
By admitting in December, you:
- Secure Your Spot: You avoid the January rush and ensure you get into the facility of your choice.
- Start 2026 Sober: Instead of starting your recovery on January 1st hungover and anxious, you start the year clear-headed, strong, and already weeks into your healing journey. You get a head start on your new life.
Let Us Check Your Benefits for Free
Insurance policies are confusing. You don’t have to figure this out alone. Our admissions team are experts at navigating insurance coverage. We can verify your benefits in minutes, tell you exactly where you stand with your deductible and out-of-pocket max, and help you calculate your potential savings.
Do not leave money on the table, and do not leave your life on hold. Contact Serenity at Summit today. Let’s make the most of your benefits before the year ends.
References
- Healthcare.gov. (2023). Deductible – HealthCare.gov Glossary. https://www.healthcare.gov/glossary/deductible/
- Internal Revenue Service (IRS). (2023). Publication 502: Medical and Dental Expenses. https://www.irs.gov/forms-pubs/about-publication-502
- National Association of Insurance Commissioners. (2023). Health Insurance Basics.
