Wellness and Health Plans
Traditionally, most health insurance plans in the United States treat sickness rather than promote wellness. In the last few years, many health insurance companies are changing their approach. Insurance companies have discovered that if they can help people stay well, it is cheaper than treating their members’ illnesses.
This shift to wellness support has advantages to you. There are three major benefits for choosing a health insurance plan that emphasizes wellness.
- 1. You get coverage for behaviors that help you stay well.
- 2. Your insurance costs may not increase as much or as quickly with a company that encourages wellness.
- 3. You stay healthier.
Health Plans that support wellness may come in the form of several names: In some cases, preventative care is bolstered in some plans that you can choose when compared side-by-side to more traditional plans. In other cases, your employer or insurance broker may offer a supplemental preventative care plan, covering anything defined as "well-care". Finally, High Deductible Health Plans, when couple with a Health Savings Account, may qualify as a wellness-oriented plan because you are encouraged to use the dollars to prevent sickness rather than treat sickness.
Stay Well with Help from Your Health Plan
A health plan that emphasizes healthy behaviors may pay at a higher rate for annual check ups and gender/age specific preventative tests. Some health plans now pay the whole cost of an annual physical. For the health plan, it means that if they can catch an illness or disease before it makes their member sick, it is cheaper. For the patient, this is an incentive to make and keep an annual physical appointment or a preventative screening test such as a mammogram or colonoscopy. While many health plans cover well-care and screenings at sporadic intervals, you may find that other plans cover more frequent screenings and pay the full cost of them. These would, naturally, incentivize the covered person to take advantage of early detection and health maintenance activities.
Some of these health plans offer discounts to health clubs or weight management organizations. The discounts provide some incentive to the plan’s members to exercise or maintain a reasonable weight, and many plans now cover life-altering improvements such as smoking cessation. If you are looking for a health plan that you can partner with to improve your overall health, such plans may be worth investigating.
Health Insurance Premiums, Cost-Sharing and Wellness
Early in the 2000s, health plan premiums were rising on an average between ten and 20 percent annually. Employer sponsored plans realized their employees needed some relief and offered plans with higher deductibles, co-payments and more cost-sharing. These plans provided a respite from the premium increases. They also passed on more out-of-pocket costs to the sickest members. It came to look a little more like car insurance -- if you are accident prone, you pay more. If you are the worlds-best driver, you pay less.
That equals a dollars and cents benefit for choosing a health plan that encourages wellness. The more a sick person uses a health plan with an emphasis on cost-sharing, the more they have to pay out-of-pocket. One solution is to not be sick, so you are not the person to pay the higher deductibles and higher co-payments. Health plans that offer this type of financial incentive for members to be active partners in staying healthy can be appealing to many consumers.
Don't completely ignore the sick care feature of health insurance, however. After all, the essence of insurance is to not be socked by catastrophic costs. While it is good to take advantage of wellness-oriented plans so you can stay healthy instead of requiring continuous care, medications, or procedures, there is always a chance that you are the victim of a bad accident or random illness. For those, be sure your catastrophic care is sufficient.