If you're fortunate to have an employer that offers health insurance, you're probably paying for a portion of the premiums out of each paycheck. But do you really know what you're paying for?
Do you work out at a local gym? It may surprise you to find out that your health-insurance plan either covers or offers a steep discount toward membership fees. Same with chiropractic services, acupuncture, massage therapy, and an array of other beneficial services.
Many employers offer financial incentives to employees who participate in corporate wellness initiatives and health-improvement programs. To remain competitive and attractive to employers looking to provide these benefits to employees, health-insurance companies are adding appealing services and perks to what they cover. That's why it pays—literally—to know what your plan covers. You very well could be paying out of pocket for products or services that your health insurance plan covers.
"Because they're generally healthy, many young people don't use the health-care system frequently, or they may still be covered under their parents' policies and believe they don't really need to know about health insurance," says Ingrid Lindberg, chief customer experience officer for CIGNA Insurance, Bloomfield, Conn. "My suggestion is that young people should take some time to understand their plan and how it works."
In a 2009 CIGNA study, almost half (46%) of those who said they're responsible for reviewing their health-care plan when it's time to enroll or re-enroll spend less than 30 minutes on the task. Because benefit information can be intimidating and confusing, it's easy to overlook some of the hidden gems you might find if you dedicated some time to become familiar with what your plan covers.
the power of preventative care
With the Affordable Care Act of 2010, health-insurance companies must provide full coverage on age-appropriate preventative services such as a yearly physical, immunizations, blood pressure and cholesterol screenings, and more.
"People should really take advantage of the preventive care that's available, because it can help them identify and address any health issues early, when they're easier to treat," Lindberg says. "Many of the employers we work with are also beginning to recognize that having a healthy and productive work force is key to their business success, and therefore, they are investing in health and productivity programs in the workplace."
Lindberg points to a growing trend in which many employers offer financial incentives to employees who participate in corporate wellness initiatives and health improvement programs. These incentives may include partial reimbursement of your health insurance premiums, movie tickets, prizes, and even cash. In addition, many employers offer onsite yearly health risk assessment and biometric screening clinics.
Some benefits starting to crop up in various health insurance plans include:
- Complementary/alternative medicine: With growing use of complementary or alternative medicine to treat illnesses and manage diseases, many plans now cover or provide discounts on chiropractic care, certain herbal remedies, acupuncture, and massage therapy.
- Health improvement: Health-insurance companies recognize that members who exercise, manage their weight, and avoid smoking drastically reduce their risk of diseases that require expensive treatment. As a result, more plans provide full coverage or discounts for smoking cessation products and programs, weight loss programs and nutritional counseling, and gym or fitness center memberships.
- Stress management/mental health: Take advantage of your company's employee assistance program for counseling and assistance at no cost to you. In addition, many health plans offer expanded mental health coverage.
- Major medical procedures: Some health plans cover larger, more expensive surgeries and treatments for infertility, as well as gastric bypass and breast reduction procedures, provided you meet criteria showing that the treatment is medically necessary.
- Vision and dental: If you have vision and dental coverage, preventive services such as an eye exam, dental cleanings, and more may be available at no cost to you. Your plan also may cover a portion of your bill for glasses and contacts—and some even cover laser vision correction and orthodontia.
- Online digital wellness coaches or one-to-one health counseling: Many plans offer direct access to online wellness coaching that you can use at your convenience. Feeling under the weather? Check the back of your insurance card to see if you have access to a 24/7 nurse phone line. These services can save you time, money, and unnecessary waiting at the doctor's office.
- Discounted prescriptions and products: Many plans have "preferred" prescriptions with a low co-pay. Other items health insurance companies may cover or discount can include anything from electronic toothbrushes to fees for participating in community-supported agriculture programs.
how to find out what you've got
Ready to find out what hidden benefits may be awaiting you? Lindberg offers these ideas to help you get started:
If you're unsure about what kind of coverage you have or what services are included in your plan, it's better to call to find out.
- Participate in your employer's open enrollment meetings or benefit fairs. Carefully review the annual benefits you're given. "Also, take the time to ask questions," Lindberg says. "The people who come to your cafeteria for a benefits fair are there to help you make informed decisions."
- Go online. When you visit your plan's website, you'll find details about coverage, a listing of in-network providers, online coaching, and much more. This is also where you'll find additional free or discounted benefits and services available to you.
- Pick up the phone. If you're unsure about what kind of coverage you have or what services are included in your plan, it's better to call to find out before you find out the hard way with a denied claim. Asking questions ahead of time can save you time and money.
By taking the time to really get acquainted with your health plan, you're less likely to face a costly financial surprise when you need to get medical care. Using your plan to its fullest not only saves you money, it could save your life as well—so don't leave valuable benefits on the table.