As December approaches, it’s easy to get caught up in holiday preparations and forget about an important deadline: December 31st marks the end of your health insurance plan year. For North County San Diego residents, taking a few strategic steps before the calendar flips can save you money and ensure you’re maximizing the benefits you’ve already paid for throughout the year.
Whether you have individual coverage through Covered California, employer-sponsored insurance, Medicare, or supplemental policies, this year-end checklist will help you make the most of your benefits and prepare for a smooth transition into 2026.
Use Your Flexible Spending Account (FSA) Funds
If you have a health FSA through your employer, remember that these accounts typically follow a “use-it-or-lose-it” rule. Any funds you contributed throughout the year that remain unused by December 31st may be forfeited (though some plans offer a grace period through March 15th or allow you to carry over up to $640 into 2026).
Smart ways to use remaining FSA funds:
- Stock up on eligible over-the-counter items (pain relievers, first aid supplies, sunscreen)
- Purchase prescription eyeglasses or contact lenses
- Schedule dental cleanings, vision exams, or other routine care
- Buy diabetic supplies, blood pressure monitors, or other medical equipment
- Pay copays for therapy, chiropractic care, or acupuncture
Action step: Check your FSA balance online or call your benefits administrator. Many FSA providers now offer debit cards, making it easier than ever to access your funds.
Schedule Preventive Care Services
Under the Affordable Care Act, most health insurance plans cover certain preventive services at 100% with no cost-sharing when you use in-network providers. These services reset each plan year, so if you haven’t used yours yet, December is your last chance.
Essential preventive services to consider:
- Annual physical exam and wellness visit
- Immunizations and flu shots
- Cancer screenings (mammograms, colonoscopy, cervical cancer screening)
- Blood pressure, diabetes, and cholesterol tests
- Well-child visits for children under 18
- Mental health screenings
Many San Diego healthcare providers are booking into early 2026, so don’t delay. Call today to secure an appointment before year-end.
Maximize Your Deductible Strategy
If you’re close to meeting your annual deductible or out-of-pocket maximum, it might make financial sense to schedule necessary medical procedures or treatments before December 31st. Once you’ve met your deductible, your insurance covers a larger portion of your healthcare costs.
Consider these scenarios:
- Close to your deductible: If you’re within a few hundred dollars of meeting your deductible, scheduling that recommended procedure now means you’ll pay less out-of-pocket this year than if you wait until January, when your deductible resets.
- Planning a major procedure: If you need surgery or another expensive treatment in early 2026, consider whether starting it in December could help you meet your deductible twice (once in 2025, once in 2026) for what might otherwise count entirely against your 2026 deductible.
- Already met your out-of-pocket max: If you’ve already hit your out-of-pocket maximum for 2025, your insurance is now covering 100% of covered services. This is an excellent time to address any outstanding health concerns at no additional cost to you.
Action step: Log in to your insurance portal to check your deductible and out-of-pocket maximum status. If you’re unsure about your coverage, call us at Serra Benefits for a personalized consultation.
Review and Refill Your Prescriptions
December is the perfect time to ensure you have adequate medication supplies and to take advantage of your current year’s prescription benefits.
Prescription checklist:
- Refill maintenance medications to start 2026 with a full supply
- Request 90-day supplies where allowed to reduce copays
- Check if your plan’s formulary (list of covered drugs) is changing for 2026
- Review whether your current medications will remain covered at the same cost-sharing level
- Ask your doctor about generic alternatives if your medication is becoming more expensive
For Medicare beneficiaries, December 7th was the deadline for making changes during Open Enrollment, but you can still review your Part D coverage and prepare for any changes taking effect January 1st.
Use Your Remaining Dental and Vision Benefits
Most dental and vision insurance plans operate on a calendar-year basis, with benefits that don’t roll over. If you have coverage through your employer or a standalone policy, make sure you’re using your annual maximums.
Dental benefits to use:
- Schedule your remaining cleanings (most plans cover two per year)
- Complete any needed fillings, crowns, or other restorative work
- Start multi-visit procedures (like root canals) that can span into 2026
Vision benefits to use:
- Get your annual eye exam
- Purchase new glasses or prescription sunglasses
- Stock up on contact lenses
- Consider upgrading to premium lens coatings or frames
These benefits typically have annual maximums of $1,500-$2,500 for dental and $150-$300 for vision. Don’t leave this money on the table!
Update Your Life Insurance Beneficiaries
While not directly related to health insurance, year-end is an excellent time to review your life insurance policies and ensure your beneficiary designations are up to date. Life changes, such as marriages, divorces, births, deaths, or even changes in relationships, may require you to update your beneficiary information.
What to review:
- Primary and contingent beneficiaries on all life insurance policies
- Employer-sponsored life insurance through work
- Individual life insurance policies
- Retirement account beneficiaries (401k, IRA)
Contact Serra Benefits if you need assistance updating beneficiary information or reviewing your life insurance coverage.
Gather Tax Documents for Healthcare Savings
If you contribute to a Health Savings Account (HSA), you’ll want to gather your contribution records for tax season. HSA contributions are tax-deductible, and the account grows tax-free when used for qualified medical expenses.
Important HSA considerations:
- 2025 contribution limits: $4,300 for individuals, $8,550 for families (plus $1,000 catch-up if you’re 55+)
- You have until April 15, 2026, to make 2025 contributions
- Keep receipts for all qualified medical expenses
- Consider maxing out contributions if you have the funds
HSAs offer triple tax advantages and can be a powerful retirement savings tool, so maximizing your contributions is often a smart financial move.
Prepare for 2026 Premium Changes
Now is also the time to review any premium changes that take effect on January 1, 2026. Insurance premiums can change annually, and understanding these changes helps you budget appropriately.
Key areas to review:
- New monthly premium amounts
- Changes to deductibles and out-of-pocket maximums
- Updates to your provider network
- Modifications to covered benefits
- Changes to prescription drug formularies
For Covered California enrollees, your renewal notice should have arrived by now. If you need to make changes or have questions about your coverage, contact Serra Benefits for guidance.
Take Advantage of Special Considerations for 2025
As you wrap up 2025, be aware of a few special considerations that may affect your health insurance benefits:
- COVID-19 testing and treatment: While the public health emergency has ended, most plans still cover COVID-19 vaccines at no cost as a preventive service.
- Telehealth services: Many insurers expanded telehealth coverage during the pandemic. Check whether these expanded benefits continue into 2026 and whether there are changes to copays or covered services.
- Mental health parity: Mental health and substance use disorder services must be covered at the same level as medical and surgical services. If you need mental health support, December is a good time to start services that may continue into 2026.
Your Year-End Action Plan
To make the most of the remaining weeks of 2025, follow this simplified action plan:
- Week 1: Check your FSA balance and deductible status. Schedule any urgent appointments.
- Week 2: Schedule preventive care appointments, dental cleanings, and vision exams.
- Week 3: Refill prescriptions and purchase any needed medical supplies or equipment.
- Week 4: Update beneficiaries, review 2026 coverage changes, and organize tax documents.
How Serra Benefits Can Help
Navigating year-end insurance benefits can feel overwhelming, but you don’t have to do it alone. Serra Benefits & Insurance Services has been serving the North County San Diego community for years, helping individuals and families maximize their health insurance coverage.
We can help you:
- Understand your current coverage and benefits
- Review your 2026 options and recommend the best plan for your needs
- Navigate Covered California enrollment and subsidy calculations
- Explain Medicare options and coordination with other coverage
- Answer questions about FSAs, HSAs, and other health savings accounts
Don’t Leave Money on the Table
Your health insurance premiums represent a significant investment in your well-being. By taking these strategic year-end steps, you’re ensuring you get full value from that investment. Whether it’s using your remaining FSA dollars, scheduling preventive care, or maximizing your deductible strategy, every action you take now can lead to better health and financial savings.
Don’t wait until the holiday rush makes scheduling impossible. Start your year-end insurance checklist today, and contact Serra Benefits if you need guidance along the way. December 31st will be here before you know it, and we want to make sure you’ve made the most of every benefit available to you.