Shocking Health Services Your Insurance Plan Might Cover
Edward Neeman | Published: June 14, 2018
You think health insurance, and you see dollar signs. With healthcare being one of the country's most lucrative industries, insurance companies couldn't possibly prioritize your well-being over their yearly revenue, right? Wrong.
Believe it or not, ensuring your health is your insurer's best bet for long-term profit. The healthier you are, the more likely you are to avoid the intensive surgeries and long hospital stays that cost you (and your insurer!) a pretty penny.
That's why health insurance plans offer incentives for you to maintain your health and well-being. Here's a list of the coolest health services and discounts you never thought your insurer would cover.
A Gym Membership
After you've had a long day at work, we know that happy hour sounds way more appealing than an hour on the treadmill. But consider this: If someone gave you $20 to hit the gym instead of going out, would you take it?
Insurance companies are hoping you would. Since regular exercise is a staple of long-term health, many insurers now offer discounts on gym fees--from $150 to $240 a year! With that financial incentive to get back in shape, you could hit the gym and have money left over for a celebratory happy hour.
Expert Opinion 24/7
If your child woke up with a fever and a hacking cough, you wouldn't hesitate to head to the ER. Better safe than sorry, right? Sure, except that "safe" in this case could mean a long wait and a hospital copay you don't want to pay for. If only you could get an expert to weigh in before you make that ER trip.
With many insurance plans, you can finally get the professional advice you need. Many insurers have a toll-free number that connects you to a nurse 24/7. Other insurers have a chat function on their website that lets your message an on-call doctor. Thanks to these round-the-clock resources, you could save yourself an exhausting night in the waiting room.
Eye And Dental Care For Kids
Because of Obamacare's 10 essential health benefits, you're automatically covered for cancer screenings, immunizations, HIV and STD testing, and other preventive services. However, to get eye and dental coverage, you'd have to add on to your existing policy or buy a separate package. If you're insuring your whole family, that extra insurance could really add up.
Luckily, one of Obamacare's other essential health benefits cuts your family some slack. For all Obamacare health plans, dependents under 19 get the same health benefits as their parents, plus routine eye and dental exams, dermatology visits, and eyeglasses and contact lenses. When your kids are guaranteed comprehensive healthcare coverage, they'll be more likely to carry their healthy habits into adulthood.
Some insurers cover vitamins and minerals at a 20 to 40% discount. If you're pregnant, most insurers will reimburse you for folic acid supplements. You might also get coupons for discounts on over-the-counter meds. As long as scientific research proves that dietary supplements are safe and effective toward overall health, insurers will probably help pay for them.
If you want to quit smoking, you'll need more than willpower. That's why Obamacare requires insurers to give members the means to quit. Although plans vary, you could get up to eight free counseling sessions and a discount on tobacco cessation meds** prescribed by your doctor.
Not all insurance plans are up to speed with Obamacare's sweeping changes, so you'll want to check with each plan before you assume it compensates you for tobacco cessation. Even if a plan doesn't offer counseling or a prescription drug discount, it might offer coupons on products and services that help you quit.
If you have any problems with anxiety, depression, addiction, or other mental health issues, don't be afraid to get help. No. 5 of Obamacare's essential health benefits requires all plans to cover counseling for mental health and substance abuse. Just check with your insurer if your coverage is limited to a certain number of sessions, or if you need a referral from your doctor.
Let's say you get a physical injury, like a broken arm. Your plan will cover your hospital care plus the equipment you get (like crutches and wheelchairs) to help you recover.
Also, because Obamacare plans offer maternity coverage, breast pumps and other maternity equipment are either completely covered or heavily discounted.
Any time you have a major illness, injury, or surgery, you have to rebuild your strength in that affected area. Physical therapy helps you do that. Thanks to Obamacare, your plan should cover some or all of your physical therapy sessions, so you have a better chance at a complete recovery.
While doctors point to diet, exercise, and sleep as the standard for maintaining good health, other health specialists are pushing for less traditional approaches to health and wellness. While most of these "alternative" forms of medicine have yet to go mainstream, three services--chiropractic, acupuncture, and massage therapy--might actually be covered by your insurance plan.
Most insurers cover chiropractic care. Depending on your plan, you might not even need a referral to see a chiropractor. However, like counseling and physical therapy, insurers might limit you to a certain number of visits, or to authorizing care only after you've gotten a referral from your doctor.
Acupuncture & Massage Therapy
Before health insurers help pay for a service, they want scientific proof that it works. Acupuncture and massage therapy have much less research done to prove their effectiveness, so they're less often incorporated into health plans.
However, acupuncture is gaining ground as an acceptable form of care. In some states, major insurance providers cover it. Even California's public health insurance program, MediCal, covers it. You might be approved if you have a diagnosis that acupuncture has been "scientifically proven" to help, like nausea from pregnancy, nausea and vomiting from chemotherapy, migraines, osteoarthritis, and back pain. Massage therapy can also treat patients with back pain.
If you want to be covered for acupuncture or massage therapy, you'll need a diagnosis from a physical therapist, physician, or chiropractor.
Weight Loss Counseling Or Surgery
If you're just trying to drop a few pounds, your insurer probably won't cover your visit to a weight loss specialist. However, if your weight puts you at risk for serious health problems down the road, your doctor can refer you to a specialist or hospital-based program.
If you have a high enough BMI or weight, you might even qualify for bariatric surgery coverage. In that case, your doctor has to refer you.
Health and Wellness Discounts
Let's say you have a very basic health plan that doesn't cover many of the services we listed. You might still get discounts on the benefits your plan doesn't cover. Some insurers get you discounted rates on "alternative" therapy sessions, herbs and supplements, fitness products, sports equipment, weight-loss programs, and personal coaches that help you quit smoking, manage stress, improve your diet, and get in shape.
Insurers are also starting to push wellness incentive programs. The HumanaVitality Program lets members rack up points for doing healthy activities, like going for a run, using a pedometer, donating blood, hitting the gym, and eating your veggies. The more points you earn, the more discounts you get for the fun stuff: electronics, movie tickets, hotel packages, and more. After all, there's no better reward for your hard work than a vacation that lets you completely unwind.
The cost of healthcare services can vary by hundreds to thousands of dollars, even from two hospitals in the same city. If you have to be treated for illness or injury, you want to know what you'll be expected to pay. Some insurers help you find out. Anthem Blue Cross and Blue Shield has a tool that lets members compare the costs of more than 1,600 healthcare services. That way, you can find a doctor or hospital with out-of-pocket costs you can actually afford.
Take Advantage Of Your Plan's Healthful Benefits
As we said before, the better your health, the less of a liability you are to insurers. While we can't tell you exactly which benefits your plan will cover, we do have an idea of the health services you should look for. To compare your options, get a free quote right here on this website. Then get one-on-one support from an expert agent who can help you decide which plans help you stay on top of your health.