Forget the political brawls and epic website crashes. When we think about the Affordable Care Act, we’re excited about an amazing list of wellness benefits we bet you haven’t heard much about — and that we think could help America’s health (and yours) make a big YOU-turn for the better.
If your health insurance coverage is affected by the federally mandated rules of the Affordable Care Act, you and your wallet might stand to earn a big real-life bonus. On tap: more screenings, vaccines and support, with no co-pay, co-insurance or deductible to meet.
Need a colonoscopy? It’s covered. Time for your flu shot? It’s included. Ready for a shingles vaccine or a pneumonia booster? Leave your checkbook at home. Need help nursing your newborn? Insurance will pick up the tab.
But that’s not all. Employers who provide health insurance will be allowed to offer an enticing carrot to their employees: sizable health care-premium discounts for following a wellness program.
By following certain guidelines, such as choosing to lose weight, exercising regularly or taking charge of a chronic health condition (like high blood pressure, high cholesterol or diabetes), you could save up to 30 percent.
You could save up to 50 percent if you stop or do not start smoking. And don’t forget to dust off your spandex shorts. You might even pick up a free or reduced-price gym membership.
The catch? The ACA also allows employers to raise rates by as much as 30 percent to 50 percent for people who don’t take doctor-recommended health steps. OUCH!
Is this unfair? Doomed to failure? We say no! We’ve seen firsthand dramatic proof that corporate wellness programs work.
At the Cleveland Clinic, where Dr. Mike is chief wellness officer, chronic disease rates were increasing by a whopping 10 percent per year among the health system’s 40,000 employees. (Yup, it’s tough staying healthy, even if you work in health care!) But they’ve reversed the curve; rates are now declining by 2 percent per year, thanks to the Cleveland Clinic’s wellness program, which includes stress reduction and anytime, anywhere support via e-coaching, along with guidance on healthy eating, lots of activity options and regular screenings.
The clinic has taken these positive results and is offering wellness programs to major American corporations and getting great results.
A case study: At one major corporation, 40 percent of employees who had metabolic syndrome (a collection of health threats that boosts the risk for heart disease and diabetes) participated in the program, and more than 90 percent of them reversed their condition.
In another, 138 out of 160 smokers who tried one of the clinic’s corporate wellness programs are now tobacco-free, an 86 percent quit rate!
And for every $1 your employer spends on wellness, the company saves about $3.37 in medical costs and more than $2 in lost workdays.
If you’re lucky enough to be covered by the ACA starting in 2014, these two strategies can help you take full advantage of your plan’s wellness benefits:
No. 1: Work with your doc if you have a chronic health condition or risk. Nobody’s going to penalize you because you haven’t lost 75 pounds in two weeks or shaped up for an Ironman Marathon in a month, so don’t believe the hype.
If you have to make healthy changes to avoid a penalty or qualify for a discount, your doctor can help you establish a plan that sets reasonable health goals for a reasonable time period.
No. 2: Taste a variety of offerings. Not every wellness benefit works for everyone. So take advantage of the variety.
Want to get active, but you just can’t get up for 6 a.m. aerobics classes? Look for an after-work class, or check out flexible options like swimming when you want or using exercise machines.
Need to relax more? If the mindfulness class you try doesn’t ring your chimes, explore yoga or progressive muscle relaxation. Chances are, several options will be covered.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. To live your healthiest, tune into “The Dr. Oz Show” or visit www.sharecare.com.
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