10 benefits you didn’t know most health plans cover

Many people are not aware of the benefits included in their health insurance plans, especially in the light of federal health care reform.

The Affordable Care Act (ACA) requires that health plans offered in the individual and small group markets cover 10 so-called “essential benefits.” These benefits run the gamut from emergency services and hospitalization, to prescription drugs and maternity and newborn care.

In addition, some states have gone beyond these federally required benefits and mandate health plans within their borders to cover additional types of services.

Finally, some insurers voluntarily have been covering services — such as alternative treatments — that typically were not covered in the past.

Following are 10 surprising health benefits that many health insurance plans cover.

1. Diet Counseling and Obesity Treatments
Thirty-three states now require health plans to cover bariatric surgery and/or diet counseling, according to the National Conference of State Legislatures (NCSL).

Bariatric surgery — which has the goal of reducing both the size of patients’ stomachs and their appetites — is now a health benefit requirement in 23 states, up from five states before passage of the ACA. Sixteen states include some coverage for dietary or nutritional screening, and seven states cover nutritional therapy if diabetes is diagnosed.

2. Smoking Cessation Programs
Some type of smoking cessation coverage is now a requirement under the ACA. The American Lung Association website breaks down what is covered.

Coverage differs depending on what type of health insurance you have. But as a general rule, people who have workplace insurance or who buy a policy in the individual market can expect coverage for four sessions of counseling and 90 days of smoking cessation medications. There is no cost-sharing — such as such as co-payments, co-insurance and deductibles — associated with these services.

Smoking cessation treatment falls under the umbrella of “mental health services and addiction treatment.” This category also covers rehabilitation and mental health treatments for other addictions.

3. Pre-Natal Folic Acid Supplements and Breastfeeding Supplies
The ACA requires most health insurance plans to cover breastfeeding support and supplies. This includes breastfeeding equipment — including the cost of a breast pump — and counseling for pregnant and nursing women.

Medela, a breastfeeding-supply company, reports that the breastfeeding provisions do not apply to Medicaid or WIC. However, breast pumps are available through WIC and many state Medicaid programs, according to Medela.

Folic acid supplements also are covered “for women who may become pregnant,” according to the U.S. Department of Health and Human Services. The department recommends that women who are or might become pregnant consume an extra 400 to 800 micrograms of folic acid every day. Folic acid is a vitamin that can prevent birth defects.

The department’s website lists covered preventive services for women, including breast cancer genetic testing, contraception, domestic and interpersonal violence screening, and screening for osteoporosis, sexually transmitted diseases and HIV.

4. Autism Screening and Therapy for Children
One in 68 children have an autism spectrum disorder, according to the Centers for Disease Control and Prevention. The Affordable Care Act requires health insurance plans to cover preventive services for children without cost-sharing. Autism screening at 18 and 24 months is part of this coverage.

As of December 2015, 43 states and the District of Columbia required health insurance plans to provide coverage of autism services, according to the NCSL.

5. Psychiatric Therapy
In 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act began to require coverage of mental and behavioral health services and substance-use disorders to be comparable to coverage of medical and surgical services, according to the American Psychological Association (APA).

For example, the APA has stated that an insurance company cannot charge a co-pay of $40 for a visit to a psychologist if it typically charges a $20 co-pay for other medical visits.

The law applies to employee-sponsored health programs with 50 or more employees, health exchanges, the Children’s Health Insurance Program (CHIP) and most Medicaid programs.

A 2014 APA survey found that more than 90 percent of Americans were unfamiliar with the mental health parity law.

6. Discounted or Free Health Clubs
One effect of the ACA is that insurance companies are vying for market share, said Sally Poblete, CEO of Wellthie, a healthcare software and analytics technology company.

“The ACA led to record high enrollment numbers and increased competition for insurance companies,” she said. “Now, more than ever, insurance companies are trying to stand out from the crowd. Part of this has created a world of creativity and innovation in benefit design.”

Fitness tracking and management is one increasingly popular benefit, she said. And some companies are going beyond merely offering deals or reimbursements for gym memberships.

“They may actually give you a wearable activity tracker or money back for healthy behavior to keep you motivated,” Poblete said.

For example, the New York-based health insurance agency Oscar has partnered with the wearable device manufacturer Misfit to pay insured members back for their physical activity as registered on the tracker, Poblete said.

In addition, many Blue Cross Blue Shield plans reimburse members for joining a health club or weight-loss program.

7. Hair Prosthesis
Are wigs considered prosthetic devices and included as essential benefits? The answer is not clear, said Robin Solomon, a Washington, D.C.-based attorney with Ivins, Phillips & Barker. She said wigs fall into a “gray area.”

“Whether they are essential health benefits is determined on a state-by-state basis,” she said. “There is no clear guidance at the federal level.”

Wigs are not specifically excluded at the federal level, but they are only included as an essential benefit if a state benchmark determines that they fall into one of the 10 essential benefit categories, she added.

Most health insurance companies that cover the cost of a wig require a prescription from your doctor, according to Breastcancer.org.

8. Gender Reassignment
According to MarketWatch, “more than two dozen major insurance carriers provide plans without blanket exclusions for transgender-related health care.” Human Rights Campaign has information at its website about how to find one of these insurers.

In addition, regulators in nine states and the District of Columbia have introduced laws banning insurance discrimination against gender-assignment treatments.

MarketWatch also reports that although the ACA does not explicitly require insurers to cover gender reassignment surgery, the White House issued a letter to insurers stating that they no longer can turn someone away just because he or she is lesbian, gay, bisexual or transgender.

9. Chiropractic Services
Chiropractic services fall into another gray area where there is no clear federal guidance, said Solomon. “Some states might treat chiropractic as ‘rehabilitative’ services, but each state can set its own limit on how many visits are covered,” she explained.

Solomon suggested checking the Centers for Medicare & Medicaid Services website, which provides benchmark details for all states for 2014 to 2017. For example, the list shows that Alabama covers $600 of chiropractic costs per year, while Pennsylvania covers 20 chiropractic visits per year.

10. Acupuncture or Massage Therapy
Some insurers are covering alternative treatments that often diverge from traditional approaches.

“Some health plans are embracing alternative medicine benefits when deemed medically necessary, including acupuncture,” Poblete said. She added that some plans also are covering massage therapy deemed medically necessary.

To find out if these services are covered in your plan, check your plan’s summary of benefits and coverage, Poblete said. “You should also take a look at the doctors in your network to see who can provide the unique services you are looking for so you can take full advantage of all your health plan has to offer,” she added.

Bellagio, MGM Resorts International’s luxury hotel turns 20
The more than 3,000-room Bellagio hotel is situated on the site of the former Dunes Hotel. The Dunes was imploded in 1993, and construction of the Bellagio started in 1996. It cost $1.6 billion to build, making it the most expensive hotel in the world at the time. The Bellagio was former Wynn Resorts Ltd. Chairman and CEO Steve Wynn’s second major casino on the Strip after The Mirage. MGM Resorts International acquired the property from Steve Wynn in 2000. (Tara Mack/Las Vegas Review-Journal)
Facial recognition software at G2E – Todd Prince
Shing Tao, CEO of Las Vegas-based Remark Holdings, talks about his facial recognition product. (Todd Prince/Las Vegas Review-Journal)
Former NBA player, Shaquille O'Neal, speaks about his new Las Vegas chicken restaurant
Former NBA player, Shaquille O'Neal, speaks about his new Las Vegas chicken restaurant. Bizuayehu Tesfaye/Las Vegas Review-Journal @bizutesfaye
Bobby Baldwin to leave MGM
MGM Resorts International executive and professional poker player Bobby Baldwin is set to leave MGM.
Caesars has new armed emergency response teams
Caesars Entertainment Corp. has created armed emergency response teams. They are composed of former military and law enforcement officials. "These teams provide valuable additional security capabilities,” Caesars spokeswoman Jennifer Forkish said. Caesars is hiring Security Saturation Team supervisors, managers and officers, according to LinkedIn. The company did not say how many people it plans to hire for the units. (Las Vegas Review-Journal)
Las Vegas, airlines prepare for CES
CES in January is expected to attract more than 180,000 attendees. (Las Vegas Review-Journal)
AGS partners with Vegas Golden Knights
AGS is the nation’s second-largest manufacturer of Class II slot machines used primarily in tribal jurisdictions. It announced a marketing partnership with the Vegas Golden Knights NHL team. (Las Vegas Review-Journal)
Lehman Brothers bet big on Las Vegas
Lehman Brothers collapsed 10 years ago, helping send the country into the Great Recession.
Fremont9 opens downtown
Fremont9 apartment complex has opened in downtown Las Vegas. (Marcus Villagran/Las Vegas Review-Journal) @marcusvillagran
Ross & Snow launches in Las Vegas
Luxury shoe brand Ross & Snow has opened in Las Vegas, featuring "functional luxury" with premium shearling footwear. (Bailey Schulz/Las Vegas Review-Journal)
Remote Identification and Drones
DJI vice president of policy and public affairs discusses using remote identification on drones. (Bailey Schulz/Las Vegas Review-Journal)
Drones and public safety in Nevada
Two representatives in the drone industry discuss UAV's impact on public safety. (Bailey Schulz/Las Vegas Review-Journal)
Frontier Airlines to launch flights from Las Vegas to Mexico
Frontier, a Denver-based ultra-low-cost carrier, will become the first airline in more than a decade to offer international service to Canada and Mexico from Las Vegas when flights to Cancun and Los Cabos begin Dec. 15. (Rick Velotta/Las Vegas Review-Journal)
MGM Resorts International CEO Jim Murren addresses Oct. 1 lawsuits
MGM Resorts International Chairman and CEO Jim Murren addresses criticism his company has received for filing a lawsuit against the survivors of the Oct. 1 shooting. (K.M. Cannon/Las Vegas Review-Journal)
MGM Resorts International opens the doors on MGM Springfield
Massachusetts’ first hotel-casino opens in downtown Springfield. The $960 million MGM Springfield has 252 rooms and 125,000-square-feet of casino. (K.M. Cannon/Las Vegas Review-Journal)
MGM Resorts International prepares to open MGM Springfield
Las Vegas-based MGM Resorts International gave news media and invited guests a preview of the $960 million MGM Springfield casino in Massachusetts. The commonwealth's first resort casino will open Friday, Aug. 24. (K.M. Cannon/Las Vegas Review-Journal)
A Walk Through Circus Circus
It only takes a short walk through Circus Circus to realize it attracts a demographic like no other casino on the Strip: families with young children. (Todd Prince/Las Vegas Review-Journal)
Morphy Auctions, a vintage slot machines seller, wants gaming license
Vice president Don Grimmer talks about Morphy Auctions at the company's warehouse located at 4520 Arville Street in Las Vegas on Thursday, Aug. 16, 2018. (Rick Velotta/Las Vegas Review-Journal)
Nevada's venture capital money doesn't stay in state
Zach Miles, associate vice president for economic development for UNLV, said there’s venture money in Southern Nevada, “but trying to find the right groups to tap into for that money is different.” According to a 2017 report from the Kauffman Foundation, Las Vegas ranked number 34 out of 40 metropolitan areas for growth entrepreneurship, a metric of how much startups grow. With a lack of growing startups in Las Vegas, investment money is being sent outside of state borders. The southwest region of the U.S. received $386 million in funding in the second quarter, with about $25.2 million in Nevada. The San Francisco area alone received about $5.6 billion. (source: CB Insights)
Neon wraps can light up the night for advertising
Vinyl wrap company 5150 Wraps talks about neon wraps, a new technology that the company believes can boost advertising at night. (Marcus Villagran/Las Vegas Review-Journal) @brokejournalist
Nevada on the forefront of drone safety
Dr. Chris Walach, senior director of Nevada Institute for Autonomous Systems, talks to a reporter at NIAS's new Nevada Drone Center for Excellence of Public Safety, located inside the Switch Innevation Center in Las Vegas. K.M. Cannon Las Vegas Review-Journal @KMCannonPhoto
Motel 8 on south Strip will become site of hotel-casino
Israeli hoteliers Asher Gabay and Benny Zerah bought Motel 8 on the south Strip for $7.4 million, records show. They plan to bulldoze the property and build a hotel-casino. Motel 8 was built in the 1960s and used to be one of several roadside inns on what's now the south Strip. But it looks out of place today, dwarfed by the towering Mandalay Bay right across the street.
Celebrity photographer dedicates dance book to Las Vegas shooting victims
Behind the scenes with local celebrity photographer Jerry Metellus as he talks about his Dance For Vegas coffee book dedicated to the 58 victims of the October 1 shooting. (Marcus Villagran/Las Vegas Review-Journal) @marcusvillagran
Dreamsickle Kids Foundation founder Gina Glass talks awareness
Gina Glass, 35, founded Dreamsickle Kids Foundation to raise awareness for sickle cell disease in Nevada. (Jessie Bekker/Las Vegas Review-Journal)
The Meadows School founding kindergarten teacher retires after 34 years at the school
Linda Verbon, founder of the The Meadows School's kindergarten program and the first faculty member hired at the school, retired in the spring after 34 years at The Meadows. (K.M. Cannon/Las Vegas Review-Journal)
Kids become firefighters at Fire Station 98 open house
Henderson residents wore fire hats, learned about CPR and met firefighters at the Fire Station 98 open house Saturday, August 11, 2018. (Marcus Villagran Las Vegas Review-Journal) @brokejournalist
People from all over the world attend RollerCon 2018
RollerCon 2018 is a five-day convention focused on the roller derby community and culture at Westgate in Las Vegas. (Marcus Villagran/Las Vegas Review-Journal) @brokejournalist
News Headlines
Add Event
Home Front Page Footer Listing
You May Like

You May Like