The Lowdown on Wellness Programs and Incentives
You may pay more for insurance or miss out on wellness incentives if you are overweight or take part in unhealthy activities such as smoking.
Over the past few years, I’ve become aware of an increasing number of employers and health insurance companies that offer wellness incentives, encouraging people to live healthy lives. I first noticed it when my employer offered me a discount on my health insurance premiums if I lived a healthier lifestyle. If I didn’t meet a set of guidelines, I could earn the discount through exercising or other means, such as certifying that I was a nonsmoker.
Then my wife’s employer instituted a wellness program that required its workers to meet certain health requirements. These included meeting weight, cholesterol, and blood pressure guidelines, as well as not smoking. If you didn’t satisfy the requirements, you didn’t get the insurance discount unless a doctor certified that the guidelines weren’t healthy for you. After the first year, the company gave you credit if your statistics improved or you met its goals.
Most recently, my wife and I joined a health care sharing ministry. The ministry charges a monthly fee if you are overweight, are a smoker, or have another preexisting condition such as high cholesterol. The fee allows us to meet with a health care coach once a month, or more often if we wish, to help us work toward our health goals. In our case, that’s weight loss.
Why do employers, insurance companies, and health care sharing ministries care about you living a healthier life? And what can you do about these incentives and fees? Here’s what I’ve learned so far.
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Why Wellness Programs Exist
Ultimately, wellness programs exist to save employers and health insurance companies money. It’s generally true that the healthier you are, the less you’ll use health insurance. This could help lower the premiums your employer has to pay and the costs that health insurance companies have to reimburse.
The idea is that if you give someone a financial incentive to live a healthier life, chances are that he or she will work toward living that life. In many cases, insurance wellness programs aim to encourage weight loss, exercise, and smoking cessation.
At my first company, I automatically got a certain amount of incentive dollars for being a nonsmoker. After that, I could earn even more for meeting weight and regular exercise goals.
Employers and health insurers will both benefit as long as the wellness incentives they offer come out to less than the amount of money they’ll save by your living a healthier lifestyle. They likely have plenty of data to calculate exactly what that cost is per person on an aggregate basis.
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Earning Wellness Incentives and Avoiding Fees
Each wellness program has its own rules, and it’s important to read the information available to you to see how yours works. You need to understand how to earn incentive dollars or get to the point where you no longer have to pay a wellness fee.
If you don’t understand the ins and outs of your program, make sure to ask. You’ll most likely find that your insurance company is more than willing to help you work toward a healthier lifestyle and explain how the wellness program works in detail.
How My Health Care Sharing Ministry Program Works
My health care sharing ministry charges participants a wellness fee to cover the cost of a wellness coach to help them achieve their goal. As I mentioned above, I’m attempting to lose weight. The company has a height-weight chart that it’s developed to determine the risk that a person’s weight poses. Once I achieve my goal according to that chart, I will no longer have to pay the monthly fee.
Some companies use body mass index (BMI) to determine weight standards, though some use other metrics.
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Until I get down to my weight goal, my health care sharing ministry lists me as a provisional member. However, it understands that life isn’t always easy and things don’t always go according to plan. My wellness coach says that as long as I make progress toward living a healthier lifestyle, I can likely stay on the plan.
Unfortunately, the ministry doesn’t cover pre-existing conditions, so gastric bypass and other similar weight loss surgeries aren’t covered. However, standard health insurance is a whole different story. If you carry it, check with your insurer to see what the company does and doesn’t cover.
That said, if I’m not making any effort, I do believe I could be removed from the plan. It’s important to realize that living healthier isn’t just about your weight. For example, if I wasn’t getting enough sleep or lived a super-stressed lifestyle, my wellness coach would work with me in those areas first before moving on to the weight issue.
I check in with my coach at least once a month, and more often if I like. So far, he’s been amazing, and is really understanding about everything we’ve discussed. I always look forward to talking to him.
Further Reading: Learn how preventative health care can save you big bucks.
How a Regular Health Insurance Program Works
Health insurance doesn’t work the same way. Instead of being removed from the plan, you just have to continue paying the higher fee your employer charges or miss out on the wellness incentives that are offered.
If it isn’t medically safe for you to reach the goals outlined in the program, you can often get a doctor to sign a form to excuse you from participating. In many cases, you can get the incentive dollars with such a note. For instance, when my wife was pregnant, it was unreasonable for her to meet the requirements her company specified. So with a note from her doctor, we got the wellness incentives, anyway.
Final Thoughts on Wellness Programs
Incentivizing healthy habits is becoming more popular with employers and health insurers because it saves them money. It also gives individuals a financial motivation to live a healthier lifestyle. I was initially upset at the fee I’d have to pay until I lost 14 pounds. But ultimately, I knew that it would be good for me. I’m excited to set off on this journey and lose the weight because it will benefit both my health and my wealth. I hope you also see the same opportunity if your insurance has a wellness program.
Those who don’t have health insurance through an employer or within a ministry can find health care plans at BestObamaCare. Some plans may offer wellness programs and incentives, so make sure to evaluate which plan works best for you.
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