Does Medicare Cover Fitness and Gym Memberships?
Unravel Medicare's approach to fitness and gym memberships. Understand the nuances of coverage and how to access potential wellness benefits.
Medicare is a federal health insurance program for individuals aged 65 or older, and certain younger people with disabilities. Beneficiaries often ask if coverage extends to fitness and gym memberships. Coverage is not straightforward, depending on the type of Medicare plan. While Original Medicare has limitations, other plans often provide fitness advantages.
Understanding Original Medicare and Fitness
Original Medicare, consisting of Part A (hospital insurance) and Part B (medical insurance), does not cover gym memberships, fitness classes, or wellness programs. It focuses on medically necessary services for existing health conditions or injuries. Beneficiaries bear the full cost for these non-covered services.
Exceptions exist where fitness activities might receive coverage. If a physician prescribes rehabilitation or therapy (e.g., physical therapy for an injury or medical condition), these services may be covered. These instances require medical necessity for recovery or treatment, not general fitness.
Medicare Advantage Plan Fitness Options
Unlike Original Medicare, Medicare Advantage plans (Medicare Part C) are private insurance plans approved by Medicare. They must cover all Original Medicare services but often include additional benefits. Fitness benefits are a widely offered supplemental benefit within many Medicare Advantage plans.
These supplemental fitness benefits offer various options for physical activity. Common offerings include full or discounted gym memberships, access to networks of fitness centers, and specialized wellness classes for older adults. Some plans also provide home fitness kits, online exercise programs, or virtual classes, offering flexibility. Specific fitness benefits vary based on the chosen plan, insurance provider, and geographic location.
Key Fitness Programs Available
Several prominent fitness programs are commonly included as benefits within Medicare Advantage plans. SilverSneakers offers access to a nationwide network of gyms and fitness centers, group fitness classes, on-demand workout videos, and social activities.
Renew Active, available through many UnitedHealthcare Medicare Advantage plans, includes a free gym membership, access to fitness locations, brain health resources, online workout videos, live streaming classes, and local health events.
Active&Fit Direct provides discounted gym memberships and at-home workout videos. Members can choose from thousands of gyms and switch facilities easily. Eligibility depends on enrollment in a Medicare Advantage plan that includes them.
How to Discover Your Plan’s Fitness Coverage
Reviewing official plan documents is a good first step to determine your Medicare plan’s fitness benefits. The Evidence of Coverage (EOC) and Annual Notice of Change (ANOC) documents, sent each fall, detail benefits, costs, and changes. They outline included services, such as fitness programs or gym memberships.
Another direct approach is contacting your Medicare plan’s member services department. The phone number is on your Medicare plan ID card; representatives can provide fitness benefit and eligibility details. For new plans or comparisons, the official Medicare Plan Finder tool on medicare.gov is a valuable resource. This online tool allows searching for Medicare Advantage plans in your area and reviewing their benefits, including fitness options. When considering new enrollment, inquire about fitness benefits during selection to align coverage with personal wellness goals.