6 Health Insurance Benefits You're Probably Not Using


Under the Affordable Care Act (ACA), better known as Obamacare, you're required to buy health insurance or face a penalty of 2.5% of your total household adjusted gross income, or $695 per adult and $347.50 per child, to a maximum of $2,085 for tax year 2016. So, take advantage of the full list of available benefits and services that come with your program, including health and wellness programs and other perks. Let's review six health insurance benefits you're probably not using — but should be.

1. Discounted Gym Memberships and Fitness Reimbursement Programs

As of June 2016, an estimated 55.3 million Americans paid for memberships to health clubs nationwide. With the average monthly gym fee around $50, gym goers are looking at a $600 expense per year before any other applicable fees, including initiation or locker rental.

Many health insurance plans offer one of two ways to lower that hefty annual gym expense. First, some companies, including Capital Health, UnitedHealthcare, and Harvard Pilgrim, offer fitness reimbursement programs ranging from $150 to $240 per calendar year (as long as you meet a predetermined minimum of consecutive months attending a gym). Some programs provide the reimbursement as a lump sum, and others do so on a monthly basis. Second, other companies, such as Kaiser Permanente, charge a flat annual fee to access a network of participating gyms. In the State of Hawaii, for example, the cost of this benefit is $100 per year, which allows you to cut down that average annual gym expense by more than 83%!

2. Home Fitness Kits and Home Trainers

Due to caretaking responsibilities, physical disabilities, or other limitations, some holders of health plans may not be able to visit a fitness facility. That's why some health insurance carriers offer home fitness kits to those unable to visit a facility or preferring to work out at home. Companies offering home fitness program, such as HealthPartners, may offer specific options for older adults. The annual fee for home fitness programs ranges from $10 to $30, allowing you to choose two to three kits from a pool of options.

Also, check with your provider on whether you can receive a discount for the services of an at-home trainer for your medical condition. For example, GroupHealth can provide coverage or discounts for participating personal fitness and exercise trainers, including yoga, tai chi, and Pilates instructors, within its network.

3. Massage Therapy

When your physician determines that physical therapy is necessary, such in the case of chronic back pain or arthritis, your insurance can help you cover a portion or even a few of your massage sessions. However, check with your plan administrator about the features of your plan. Some plans may offer you one massage therapy session per month at a deeply discounted price in a participating facility within their network and others may offer a discount on massage therapy sessions on an ongoing basis (as long as you use service providers within their network).

4. Vaccines and Screening Tests

Thanks, Obama. Under the ACA, most health plans must cover a list of preventive services, including vaccinations and screening tests, at no charge to you. Some eligible preventive services for adults include HIV screening, colorectal cancer screening for adults over age 50, and aspirin use to prevent cardiovascular disease. Many immunization vaccines, including Hepatitis A, Herpes Zoster, and influenza, are also covered. This second benefit can be quite useful during times of outbreaks, such as the 2016 Hepatitis A outbreak on the Island of Oahu. Remember to stay within your network of providers to avoid any charges. (See also: 7 Places to Get Vaccinated for Cheap or Free)

5. Breast Pump and Breast-feeding Counseling

With the average cost of raising a child under age two estimated at $12,940 per year, parents are always looking to save a buck. Your health insurance plan offers parents a way to save a couple hundred. All health insurance plans must cover breast-feeding equipment and counseling for the duration of breast-feeding.

Since the cost of an electric breast pump ranges between $100 and $350, we're talking about some serious savings. For example, my wife's plan fully covered a new Medela pump, retailing for almost $300 at a store within her network. Check the rules of your plan for eligible retailers and breast pump models. (See also: 8 Money Moves to Make When You Find Out You're Pregnant)

6. Weight Loss Benefit

Some health insurance carriers provide subsidies toward fees for eligible Weight Watchers, at-work, or hospital-based weight loss programs. For example, Blue Cross Blue Shield of Massachusetts, offers up to $150 per calendar year.

If your main resolution this year was to lose some weight, then you can combine your potential weight loss and discounted gym membership benefits to re-energize your promise to get back in shape and improve your health.

What are other health insurance benefits we're probably not using?

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Anonymous Doctor

There is some misinformation above that can cause false impressions related to treatment of back pain and confusing massage therapy and physical therapy as synonymous. Physical therapists evaluate and treat movement disorders with exercise, movement modifications, joint and soft tissue mobilization techniques.

To also suggest to someone the impression that their doctor should send them to physical therapy for massage as the main objective to treat chronic back pain is misguided, because back pain is diverse in subtypes can be caused by many other factors. Medical research does not strongly support massage as the most effective treatment for all types of low back pain either, as treatment effectiveness really depends on the cause and structures involved.

Anonymous Doctor