Your NALC Health Benefit Plan covers more than sick care. It’s built around a full suite of wellness programs designed to help you stay healthy, manage ongoing conditions, and get support before a small concern becomes a bigger one. Many members aren't using everything available to them, and the programs to enhance your well-being already in your plan are a good place to start.
Preventive Care: Your First Line of Defense
Preventive care is one of the most direct ways to protect your health, and the Health Plan covers preventive services at no cost when you use a preferred provider. That means annual routine physicals, recommended screenings, immunizations, and childhood vaccines among them, are covered without a copay or deductible.
Biometric screenings are also part of your preventive care coverage. These measure BMI, waist circumference, total cholesterol, blood pressure, and fasting blood sugar, giving you and your care team a clear and current picture of where your health stands. Completing your annual biometric screening also qualifies you for wellness rewards. See the "Wellness Rewards Program" section below for more details.
Your plan-specific preventive care details are on the High Option preventive care page and the CDHP preventive care page.
Fitness, Nutrition, and Health Coaching: Building Healthier Habits
The Plan connects you with one-on-one health coaching from trained nurses, nutritionists, and clinicians at no additional cost. No referral is required, and programs are available in all states. Coaching covers nutrition, sleep, exercise, weight management, stress, and tobacco cessation. Call 888-636-NALC (6252) or explore all available coaching programs to find the right fit for your goals.
For weight management specifically, members can enroll in Real Appeal®, a yearlong program that combines coaching, group support, and a free Success Kit with a food scale, portion plate, and fitness resources. Members using weight loss medication can access the CVS Rx Weight Management Program for additional clinical support alongside their prescription.
Beyond weight and nutrition, The Plan partners with Quit for Life® for tobacco cessation, Hinge Health® for joint and muscle health, Hello Heart® for cardiovascular tracking, Bend Health® for behavioral coaching for children and teens, and Maven® for family and pediatric wellness support.
Mental Health and Substance Use Support: Care Is Always Available
Mental health benefits are part of your plan and cover a wide range of needs, from outpatient therapy to inpatient treatment to substance use recovery. Coverage details vary by plan.
High Option members have their mental health benefits managed through OptumHealth Behavioral Solutions, with a network of over 526,977 in-network clinicians, 240,348 telemental health providers, and 5,492 facilities across 10,200 locations nationwide. In-network outpatient therapy and medication management is covered with a $25 copay and no deductible. Virtual telemental visits are $10 and no deductible, and inpatient hospital admissions are $350 per admission, no deductible.
High Option members also have access to Bend Health® for children and family behavioral coaching, a Solutions for Caregivers program with six hours of personalized support per year, and on-demand mental wellness tools at liveandworkwell.com. Substance use disorder support is available 24/7 by calling 855-780-5955. The High Option mental health benefits page has the complete cost and coverage breakdown, and Optum can be reached at 877-468-1016 for preauthorization or provider matching.
CDHP members have their benefits managed through Cigna, with access to over 615,737 in-network clinicians and 8,068 facilities. In-network outpatient therapy and medication management is covered at 20% of the Plan allowance, virtual telemental visits at 10%, and inpatient hospital care at 20%. Virtual therapy and psychiatry are also available through MDLIVE at MDLIVEforCigna.com or 888-726-3171.
CDHP members who want to understand how their Personal Care Account can offset therapy costs will find that PCA funds apply to eligible mental health services before standard cost-sharing kicks in. Cigna Behavioral Health can be reached at 855-511-1893, for additional details please visit the mental health benefits page.
For both plans, preauthorization is required for inpatient admissions, residential treatment centers, intensive outpatient programs, partial hospitalization, and psychological testing.
Chronic Condition Management: Sustained Support for Long-Term Health
Both the High Option Plan and the CDHP connect members managing chronic or complex conditions with condition-specific programs, care coordination, and specialist support. Members who want a practical guide on making the most of these resources will find that navigating chronic condition support effectively starts with knowing which program applies to their situation.
Accordant Health Management® provides one-on-one nurse-led coaching and care coordination for members with rare or complex conditions across 19 diagnoses: ALS, Crohn's Disease, Cystic Fibrosis, Dermatomyositis, Gaucher Disease, Hemophilia, Hereditary Angioedema, HIV, Multiple Sclerosis, Myasthenia Gravis, Parkinson's Disease, Polymyositis, Rheumatoid Arthritis, Scleroderma, Seizure Disorders, Sickle Cell Disease, Systemic Lupus Erythematosus, CIDP, and Ulcerative Colitis. To enroll, call 844-923-0805.
For members managing conditions like asthma, COPD, depression, diabetes, and heart disease, the Priority Health Coaching Program through Cigna is specifically designed for long-term condition management rather than general wellness goals. It connects you with nurses and health advocates for medication guidance, symptom tracking, and care continuity. Members managing cardiovascular disease will also benefit from understanding how consistent medication adherence supports long-term heart health, particularly for those on statins. High Option members can reach Priority Health Coaching at 877-220-NALC (6252); CDHP members at 855-511-1893.
Members managing diabetes have access to Transform Care®, a no-cost program that provides a connected glucometer, unlimited test strips and lancets, pharmacist counseling, and two annual diabetes screenings at a CVS MinuteClinic®. Call 855-238-3622 to get started.
CVS Specialty helps manage complex conditions which require specialty medications, biologics, biotech therapies, oral chemotherapy and gene-based treatments (Prior authorization is required). CVS Specialty also provides home delivery, clinical case management, and access to third-party copay assistance programs. For 2026, High Option members pay $200 for a 30-day supply, $350 for 60 days, and $500 for 90 days. CDHP members pay $250 for 30 days, $450 for 60 days, and $650 for 90 days.
The Wellness Rewards Program: Get Rewarded for Taking Action
Your plan rewards you for actively engaging with your health across all the areas covered in this article. The Rewards & Incentive page on our website covers everything you need to know to start earning your 2026 incentives.
Ready to Use Your Benefits?
Your wellness benefits are already part of your plan. Log in to your member portal to review what’s available to you, or contact our Customer Service team at 888-636-NALC (6252) for guidance on where to start.
