"What healthcare benefits expire on December 31?"

"Flexible Spending Accounts (FSAs) typically expire December 31 unless your employer offers a grace period (until March 15) or carryover (up to $640). Dental and vision insurance benefits also reset annually, meaning unused coverage doesn't roll over. Some deductibles and out-of-pocket maximums reset January 1 as well."

"How much FSA money do people forfeit each year?"

"According to the Employee Benefit Research Institute, about half of FSA account holders forfeit money each year, with an average forfeiture of $441 per person. This happens because FSA funds follow 'use it or lose it' rules, and unspent money typically doesn't roll over to the next year."

"What's the difference between FSA and HSA expiration rules?"

"FSAs generally expire at year-end (with possible grace periods or limited carryover), while HSAs never expire and roll over indefinitely. HSA funds also remain yours even if you change jobs. For 2025, HSA contribution limits are $4,300 for self-only coverage and $8,550 for family coverage."

"Why are January insurance premiums higher?"

"January premiums feel higher because they reflect the new plan year's rates. According to the KFF 2025 Employer Health Benefits Survey, employer-sponsored family premiums reached $26,993 annually, up 6% from 2024. Workers contribute an average of $6,850 per year toward family coverage."

Mark Scott

December 10, 2025

End of Year Medical Bills: The Complete Use It or Lose It Guide

📖 4 min read

Person reviewing medical bills and insurance documents at desk during year-end planning

FSA funds, dental maximums, and vision allowances all vanish December 31. Then January hits with higher premiums and reset deductibles. Here's your game plan.

Open your benefits portal right now. See that FSA balance? That dental coverage you’ve barely touched? The vision benefit you forgot about? If you don’t use them by December 31, they’re gone. Then January hits and you’re dealing with higher premiums, reset deductibles, and a whole new year of out-of-pocket costs.

The Reality: About half of FSA holders forfeit money each year—an average of $441 per person^[1]. That’s money you earned, set aside for healthcare, and lost because the deadline slipped by.

↑ TopWhat Expires December 31

Here’s why FSA deadlines catch so many people off guard: you contribute money all year, use it sporadically, and then realize in late December you’ve got hundreds of dollars that vanishes in days. The rules are unforgiving:

Rule Type	Details
Standard deadline	December 31 (funds forfeited if unused)
Grace period option	Some employers extend until March 15
Carryover option	Some employers allow up to $640 to roll over
2025 contribution limit	$3,300 maximum

Your employer chooses grace period OR carryover, not both. Check your plan documents now to know which applies.

FSA-eligible expenses include copays, prescriptions, dental work, vision care, OTC medications (no prescription needed since 2020), and supplies like first aid kits and sunscreen. For last-minute spending strategies, see our FSA deadline guide.

Dental and vision work the same way. Most dental plans have an annual maximum ($1,000-$2,000) that resets January 1—if you’ve only used $400 of $1,500 in coverage, that remaining $1,100 disappears. Vision plans typically cover one exam and one pair of glasses per year; unused benefits vanish with the calendar. December is brutal for booking appointments because everyone’s doing this at once.

If bills pile up while you’re rushing to use benefits: You can split medical costs into 4 payments over 8 weeks with Deferit. See if you qualify.

What Resets January 1
December Strategy: Use It Before You Lose It
January Challenge: Managing the Reset
Year-End Healthcare Checklist

↑ TopWhat Resets January 1: Brace for Impact

That first January paycheck feels smaller for a reason: new premium rates kick in, and they’ve been climbing 6% year over year^[3].

Coverage Type	Annual Premium	Your Contribution
Family coverage	$26,993	$6,850/year
Single coverage	$8,951	Varies by employer

But premiums are just the first hit. On January 1, your deductible resets to zero—that $1,886 (single) or $3,000-5,000+ (family) you already paid this year? You start over. Same with your out-of-pocket maximum. If you’ve met it, you’re currently getting maximum value from your insurance. Come January, you’re back to full exposure.

For strategies to manage January premiums, see our January insurance premium guide.

↑ TopThe December Strategy: Maximize Before Year-End

If you’ve met your deductible: Your insurance is covering the most it will all year. Schedule that imaging test, physical therapy, or specialist consultation you’ve been putting off. After January 1, you’re back to paying full price until you meet the new deductible.

If you have FSA funds remaining: Prioritize scheduled medical care (copays, lab work), dental work, vision care, then stock up on eligible items like contact solution, first aid supplies, and OTC medications. Many retailers verify FSA eligibility at checkout.

If you have unused dental/vision: Book now. December is the busiest month—ask to be added to cancellation lists if nothing’s available.

↑ TopThe January Challenge: Managing the Reset

January hits hard: higher premiums, reset deductibles, post-holiday bills, and medical needs that don’t wait for your budget to recover. Budget for increased Q1 healthcare spending, especially if you have ongoing medical needs.

Timing matters for elective care: schedule in December if you’ve met this year’s deductible, or wait until later in the year if you expect to meet next year’s through other care. But don’t delay necessary care for financial reasons—untreated conditions become more expensive over time.