January 1 is a reset button for a lot of health plans. Not all of them. And not every part of the plan runs on the same clock.
Deductible and out-of-pocket maximum
ACA individual plans run on the calendar year. Whatever you've paid toward the deductible and the out-of-pocket maximum goes back to zero on January 1.
Some medically underwritten plans run on a policy year instead, so the reset lands on the anniversary of the policy. Your plan documents say which kind you have. Most member portals show it too, on the page that tracks how much you've met.
The out-of-pocket maximum is the most you pay for covered, in-network care in a plan year. Premiums don't count toward it. On an ACA plan, once you reach it, the plan pays for covered in-network services for the rest of that year. Underwritten plans can count things differently, so read yours before you lean on it.
If you've already paid a good chunk of this year's deductible, care you need anyway may cost less before December 31 than after. That's a conversation for you and your doctor. It isn't a reason to book things you don't need.
Preventive care
On an ACA plan, the listed preventive services are generally covered at $0 in network. Many underwritten plans handle preventive care another way, with a copay, a dollar cap or a waiting period. Check before you book a checkup counting on $0.
Dental
Most dental plans have an annual maximum, the most the plan pays in a benefit year. Whatever you don't use is gone when the year turns over. On a calendar-year dental plan, that's January 1. Some reset on the anniversary instead.
If a dentist has already recommended work, ask whether splitting it across December and January makes sense on your plan.
FSA: a hard clock, mostly
A health FSA comes through an employer. For 2026 the limit is $3,400. Money left at the end of the plan year is lost unless the employer's plan offers one of two exceptions:
- a carryover of up to $680 into 2027
- a grace period of up to two and a half months, which is March 15 on a calendar-year plan
A plan can offer one of those or neither. Never both. The plan papers from your employer say which.
Some plans also have a run-out period after the year ends. That's only for filing claims on money you already spent. It doesn't buy you more time to spend.
The IRS usually announces next year's FSA limit in October or November, so check your plan's 2027 limit before you pick your contribution.
HSA: no clock at all
An HSA works the other way. The money is yours. It rolls over every year and stays with you if you change plans or jobs.
For 2026 you can put in up to $4,400 with self-only coverage or $8,750 with family coverage, plus $1,000 more at 55 or older. For 2027 the limits rise to $4,500 and $9,000.
To contribute, you need an HSA-qualified health plan behind the account, and not every plan qualifies.
Four things to look up before December 31
- whether your plan resets on January 1 or on an anniversary
- how much of your deductible you've met
- your dental benefit year
- your employer's FSA rule: carryover, grace period or neither
Not sure which kind of plan you have? Book a time with me and we'll find out.
Sources:
- IRS Rev. Proc. 2025-19 (2026 HSA limits)
- IRS Rev. Proc. 2026-24 (2027 HSA limits), May 2026
- IRS Rev. Proc. 2025-32 (2026 FSA limit and carryover)
- IRS news releases IR-2023-208 (Nov 9, 2023), IR-2024-273 (Oct 22, 2024) and IR-2025-103 (Oct 9, 2025), the 2024 to 2026 FSA limits
- IRS Publication 969 (carryover and grace period rules)
- HealthCare.gov, preventive care benefits
Mary Jones, licensed health insurance agent, NPN #20192176. Jones True Insurance Solutions. Not affiliated with HealthCare.gov, Nevada Health Link or any government agency. A licensed agent may contact you.
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