ACA health plans increasingly offer wellness incentives

ACA individual-market insurers get into the rewards business

Most Americans are familiar with the idea of workplace wellness programs that offer rewards for various activities and behaviors – such as getting an annual checkup or taking a certain number of steps each day. But what about people who buy their own health insurance?

Health insurance companies are increasingly offering incentive programs for individual/family enrollees, but you might not know about them unless you ask. These rewards programs are fairly new in the ACA-compliant individual market, with most debuting in just the last year or so.

Once you’re enrolled in an ACA health plan, your carrier will send you information about any rewards they offer. But knowing about the various programs before you enroll is another useful metric when you’re selecting your coverage. You can ask your agent or broker about wellness incentives being offered by insurers that offer individual/family plans in your area. You can also reach out to the insurers directly, by phone or via their websites, to see whether they offer any wellness programs.

With that in mind, let’s take a look at the incentive programs that some of the major health insurers are offering on their individual/family health plans for 2022.

Multiple health carriers offering plans with wellness incentives

Several insurers that offer widespread coverage in multiple states’ health insurance marketplaces are offering wellness rewards as of 2022 (note that although these insurers offer plans in many states, they are not available in all states and some states may have unique rules for wellness incentives):

• Ambetter: With Ambetter’s My Health Pays program, plan enrollees earn points for certain actions, including an annual wellness exam and preventive screenings, disease management, online surveys, and various healthy activities. Members who complete all of the available activities can earn enough points to receive $500 in rewards – and those rewards can be redeemed to cover out-of-pocket health care costs, utilities and other monthly bills, and various other everyday financial needs.
• Anthem: With Anthem’s Smart Rewards program, enrollees can earn $25 when they see their doctor for a well-check within 90 days of the date their plan takes effect. Policyholders can also earn $20 for completing a health assessment.
• Bright: With Bright HealthCare Rewards, enrollees can earn up to $500 in rewards for completing various activities. Members sign up for the program by creating a Member Hub account, and can use that account to track their rewards throughout the year. Members receive a VISA card, and rewards are added to the card as they are earned. Policyholders rewards are earned for activities that include joining the plan’s rewards program, selecting a primary care physician, completing a health risk assessment, and opting to receive communications from Bright HealthCare.
• Cigna: With Cigna’s Take Control Rewards program, plan buyers can earn up to $275 that can be used to cover healthcare costs or purchase a variety of merchandise, including tech gadgets and sporting equipment. After enrollment in the rewards program, members complete a brief health assessment and then start earning rewards for actions such as getting an annual physical and flu shot, and participating in online wellness activities.
• Molina: With Molina’s My Health Perks program, members can earn a $50 gift card if they see their primary care provider for an annual wellness exam and complete a Health Risk Assessment on the My Molina portal.
• Oscar: With Oscar’s Step Rewards program, members can earn up to $100 per year by syncing a step tracker with the Oscar app, and hitting daily step goals. Members can earn $1/day when they meet step goals, up to $100/year, redeemable for an Amazon gift card.
• UnitedHealthcare: Enrollees can receive one year of free access to the Peloton app, plus discounts for certain health clubs and online coaching programs. Enrollees who complete an annual visit with their primary care provider can get a $25 gift card to Walmart, Walgreens, or Amazon.

Other companies offer members discounts on a variety of wellness-related services, such as meal plans, yoga classes, gym memberships, and weight management programs. Examples include the wellness discounts offered to Aetna/CVS members, and Friday Wellness Extras for people with coverage from Friday Health Plans.

Smaller, regional insurers also offer incentive programs

The list above only includes the large insurers that offer plans in numerous states. Your marketplace may include smaller, regional insurers that offer their own rewards programs.

For example, Moda Health – which offers plans in Alaska, Oregon, Texas, and Washington – has a program that provides discounts on Fitbit devices and free access to Fitbit Premium and coaching. True Health – which offers plans in New Mexico – allows members to earn points that can be cashed out for gift cards. And Independence Blue Cross – which offers plans in Pennsylvania – offers a $100 gift card when plan enrollees complete a list of wellness-related activities, including your annual checkup and flu shot.

Although there are several big-name insurers that participate in the marketplaces in numerous states, most of the insurers that offer marketplace plans tend to be regional and localized. In just the 33 states that use HealthCare.gov as their marketplace, there are a total of 213 insurers offering plans for 2022.

So if wellness rewards are important to you, ask your insurance broker if any of the available plans include those types of perks, or reach out to the insurers directly and see what’s available.

How much should wellness incentives factor into your choice of coverage?

Wellness rewards from your health insurance company are a nice perk. But they shouldn’t overshadow the major factors that you’ll want to keep in mind when comparing plans. Factors such as your expected out-of-pocket costs, whether you’ll need to switch doctors, and whether/how your prescription drugs will be covered are likely to be more important in terms of the overall benefits you’ll get from the plan.

And if you want to be able to contribute to a health savings account, you’ll need to select from among the HSA-qualified high-deductible health plans in your area, which might limit your insurer options somewhat.

But once you’ve narrowed down your plan options based on the overall benefit design and network, factors such as quality (star) ratings and wellness rewards can help you make a final selection.

And keep in mind that the benefits of the wellness rewards go beyond just the financial benefit. If a cash reward from your insurer is the motivation that gets you to the pharmacy for a flu shot, it might end up being the thing that ultimately keeps you from ending up in the hospital with a bad case of the flu (note that in order to get a wellness reward for getting a flu shot, you’ll need to make sure that you give the pharmacy your health insurance information, even if free flu shots are available at the pharmacy without insurance coverage information).

And if you know that you’ll be more motivated to get your wellness check or meet your step goal if there’s a gift card waiting for you, a plan that offers those perks might help you stay healthier throughout the year.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.