Take Advantage of Wellness Programs From Your Health Insurance

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While experts debate whether preventive measures lower healthcare costs on a national level, there's plenty of evidence that prevention is beneficial when it comes to your individual health—and your wallet.

Of the 10 most common causes of death, including heart disease and cancer, half are related to lifestyle choices, according to the Center for Bioethics and Human Dignity. Keeping your weight down, quitting smoking, staying fit, and reducing stress are some of the best ways to prevent illness and prolong life, and they could reduce the amount of money you have to spend on hospitalization, drugs, and other therapies.

If you have health insurance, you probably know that in most cases, preventive medical checkups—such as yearly physicals and OB/GYN visits—are covered. But you may not know that some plans also offer wellness options that may help pay for exercise or weight-loss programs.

Insurers Trending Toward Prevention

Gym memberships, weight-loss clinics, weight-loss surgery, massage therapy and stop-smoking programs are just a few of the items included in some insurance plans. Blue Cross Blue Shield of Massachusetts even offers a discount on electric toothbrushes to help prevent cavities.

More insurance companies have begun partnering with health clubs to offer discounted memberships or services. The benefits cover everyone, from the super-fit to those with chronic medical conditions, according to J.P. Wieske, of the Council for Affordable Health Coverage.

"It doesn't matter if you've got serious diabetes or hypertension and all you can do in the gym is walk slowly," Wieske says. "It's the same benefit to that person as it is to a gym rat who's there every single day."

Promoting Healthy People and Budgets

It pays to take advantage of any preventive benefits that come with your insurance policy. Some examples of possible savings include:

  • Weight-loss surgery: Though not a concern for most people, it can be a huge savings for the obese. If your body mass index is 40 or more, or you have respiratory problems, diabetes or high blood pressure aggravated by obesity, you may qualify for coverage for a gastric bypass or gastric banding surgery. If yours costs an average $20,000, your deductible is $500 and your co-pay is 30%, then you'll pay about one-third of the cost.
  • Gym membership: Some United Health Care plans include 10 to 50% discounts on specific health club memberships. If your gym plan takes $30 a month out of your checking account, a half-off discount will save you $15 each month.
  • Weight-loss program: Not many policies cover weight-loss programs like Jenny Craig or Weight Watchers, but look for that to change in the future, Wieske says. One benefit now available through Aetna to Kraft Foods Inc. employees offers a 30% discount on such programs, which brings the cost of one popular $199 plan to $139.
  • Orthopedic massage: A one-hour, stress-busting therapeutic massage at Massachusetts Blue Cross Blue Shield participating facility Boston Bodyworker is normally $115, but the 25% insurance discount makes it $86. No documentation of any medical condition is necessary to get coverage.

Only a few insurers cover smoking-cessation programs and medications, which are mostly over-the-counter. But if you talk with your doctor about quitting during a routine physical, that visit will be covered. Those rare policies that do help with the cost of formal programs that include counseling can save you hundreds of dollars, on top of the $650 or so that pack-a-day smokers who kick the habit will save in a year's time.

To find out what wellness benefits you may have, contact your insurance company or your employer.

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  1. Council for Affordable Health Coverage. About.

  2. Duke Health. Is weight loss surgery covered by insurance? Your questions answered. Updated February 28, 2019.

  3. Aetna. Weight reduction medications and programs. Updated May 22, 2019.