6 Surprising Benefits Your Health Insurance May Cover (2024)

Health insurance is practically synonymous with headaches: deductibles, co-pays, out-of-network doctors, explanation of benefits, the ObamaCare website.

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But it's not all agony and Advil. Turns out, your health care may cover a lot more than just physicals and hospitalization. Here are six benefits you might not realize your plan includes.

The article "6 Surprising Benefits Your Health Insurance May Cover" originally ran on MensHealth.com.

"Across the board, people now have better access to mental health," says Dylan Roby, PhD, a professor at the University of Maryland's School of Public Health and a researcher at UCLA.

Coverage may include things like psychotherapy and counseling, inpatient services, substance abuse and alcohol misuse treatment, depression screening, and preventative services.

That's because under the Affordable Care Act (ACA), non-grandfathered plans are required to cover some major essential health benefits (EHBs), like mental health treatment.

And most of these plans have to provide parity when it comes to mental health.

That means if your plan covers three primary care visits a year, you're also entitled to three covered mental health appointments. If you have a $20 co-pay for a prescription for diabetes, you should pay no more than that for an antidepressant, Roby explains.

Did you know that 19 states consider infertility treatment an EHB?

While the details of that treatment vary from state to state—and are usually far from complete in terms of covering expensive costs—Roby says that benefits could lessen the blow on everything from screening and tests to in vitro fertilization (IVF) costs if you're trying to get pregnant.

And that's huge, considering that IVF, which has a 40% success rate, can cost upwards of $20,000 for each attempt to have a child.

Eighty to 90% of Americans will suffer from back pain in their lifetime. Luckily, 45 states cover chiropractic care.

Of course, Roby notes that each state and each plan decides—based on state law—what the requirements are for coverage.

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For example, in some states, you might be able to self-refer to a chiropractor for alignment or therapy, and they will bill your insurance company; in other states, your doctor might have to refer you, he says.

If you live in Alaska, California, Maryland, New Mexico, or Washington and holistic healing is your thing, you're in luck: These states cover the costs of the ancient practice as an EHB.

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What's more, some plans at big-name health insurance companies like Harvard Pilgrim and Blue Cross Blue Shield also cover the service through specific plans in Connecticut, Massachusetts, Maine, and New Hampshire.

"We are seeing a movement toward more and more plans offering gym memberships as a way to facilitate better health for employees," says David Jones, an assistant professor of health policy and management at Boston University's School of Public Health.

The idea goes back to something you already know: Exercise not only increases your physical health, but also improves your mood and helps you manage stress more effectively.

The setups vary from plan to plan. Plans could subsidize the monthly fee, pay for 3 months of the membership, or give you a credit toward your monthly premium if you join a fitness center.

In Maryland, Roby says that all state employees have the option to fill out a questionnaire, go to their doctor for a physical, and send the results to their insurance company. If you do that, you get a discount on your premium and free co-pays for your primary care appointments for the next year. Plus, the ACA generally allows employers to discount premiums for people who work out, says Roby.

One in three Americans is obese—and faces health challenges because of it.

Now, health insurance is catching up to help out: 45% of states cover bariatric surgery for weight loss if medically necessarily; and four—Massachusetts, Michigan, Montana, and New Mexico, plus Washington, DC—cover weight loss programs.

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What’s more common, though, is nutritional counseling, which is available in 25 states. While this usually doesn’t mean a free Weight Watchers membership, it could mean you can be referred to a nutritionist by your doctor or that you can be assigned one through a hospital if you’re being treated for a condition like diabetes, says Roby.