FAIR Health Consumer Access

Coverage for Healthy Families

Many health plans offer family benefits that can help you and your loved ones stay or get healthy. Fall is a good time to review health benefits for the whole family. That’s because many employers have open enrollment in the fall. Check out our article Fall Is Open Enrollment Season in this issue. Health plan family benefits can include coverage for physical fitness, preventive care (such as well-child visits) and other family benefits.

Coverage for Family Physical Fitness
The CDC (Centers for Disease Control and Prevention) says staying active has many advantages for children and adults. Some advantages include better brain health and lower risk of long-term health issues, such as type 2 diabetes and obesity. For children, staying active may also help them do better in school. And for adults, it may help you sleep better. Many health plans offer help to get or stay active. For example, your plan may offer family activity tips and reimbursements for gym memberships and workout equipment. Check your plan’s benefits to see what’s offered.

Coverage for Well-Child Visits
Well-child visits are regular preventive care visits with your child’s doctor. Preventive care services help find some health problems early on and stop others before they begin. They include screenings for babies and young children. Such screenings involve blood tests for newborns to check for certain health issues, such as hypothyroidism (low thyroid hormone). The screenings also include teeth and gum health checks for six-month-olds to six-year-olds. Well-child visits also include developmental screenings that check how your child is growing and changing over time. These help you know if your child is developing on track for their age. Children of all ages can also get the shots recommended by their doctor to help prevent some illnesses. Find out more about what’s included in children’s preventive care on healthcare.gov.

Preventive care is covered by most health plans at no cost. That means you won’t have to pay a copay or coinsurance for a well-child visit. Double check with your health plan to make sure it covers preventive care. Some older plans might not. And read our article on preventive care and wellness services to find out more about coverage and costs.

Healthy teenagers. The National Institute of Mental Health says teens may react differently to stress than adults. This may make them more likely to suffer from mental health conditions, such as depression and anxiety. Well-child visits for teens include screenings for drug, tobacco or alcohol use and depression, among other things. Some plans also cover behavioral health programs to tackle other potential teen concerns, such as screen addiction. Check what your plan offers and ask your child’s doctor about what services are available.

Medicaid and Medicare Coverage for Healthy Children and Families
Medicaid and CHIP cover a range of health benefits for children and families. These include preventive care and adolescent mental health. Find out more about Medicaid mental health coverage for children here. Medicaid coverage varies by state, but in some states, fitness programs are covered. Find your state’s Medicaid office here.

Medicare covers individuals and not families. However, children with certain health issues, such as severe kidney disease, can get Medicare coverage. Original Medicare doesn’t cover fitness programs, such as gym memberships. But if you have a Medicare Advantage plan, you may be covered for some fitness and wellness benefits. Find out more about Medicare in our article here.

Other Healthy Family Benefits Offered by Your Health Plan
Many health plans offer other benefits to help your family stay healthy, such as personalized digital resources. Some of these may include health trackers, family planning articles and developmental updates. They may also include to-do lists, one-on-one health coaching sessions and pregnancy support. Check with your plan to see what else it offers to help keep you and your family healthy.