Does My Medicare Cover a Gym Membership?

Medicare is a federal health insurance program that provides coverage for millions of Americans. This article clarifies how different parts of Medicare and supplemental plans approach coverage for fitness activities.

Medicare Part A and Part B Coverage

Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance), provides coverage for a range of healthcare services. Part A primarily covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Part B covers doctor visits, outpatient care, durable medical equipment, and some preventive services.

Original Medicare does not cover gym memberships, fitness classes, or health club dues. These services are not considered medically necessary under Part A or Part B. Individuals with only Original Medicare are responsible for the full cost of these fitness-related expenses.

Medicare Advantage Plan Coverage

Medicare Advantage Plans, often referred to as Medicare Part C, offer an alternative to Original Medicare. These plans are provided by private insurance companies approved by Medicare and must cover all the benefits of Medicare Parts A and B. Many Medicare Advantage plans also include additional benefits that Original Medicare does not cover, such as prescription drug coverage, dental, vision, and hearing services.

A benefit offered by many Medicare Advantage plans is coverage for health and wellness programs, which include gym memberships. These programs aim to promote physical activity and overall well-being for members. Common examples of such programs include SilverSneakers, Renew Active, and Silver&Fit, which partner with a network of fitness centers. These programs may offer access to gyms, fitness classes, and even online resources.

Supplemental Medicare Plan Coverage

Medicare Supplement Insurance Plans, also known as Medigap plans, serve a different purpose than Medicare Advantage plans. Medigap plans help cover some of the out-of-pocket costs not paid by Original Medicare, such as copayments, coinsurance, and deductibles. These plans work alongside Original Medicare, rather than replacing it.

While Medigap plans are primarily designed to help with medical costs, they do not directly cover gym memberships as a standard benefit. However, some Medigap plans from certain private insurers may offer limited health and wellness benefits. These benefits might include discounts or access to fitness programs, but they are less comprehensive than the wellness benefits commonly found with Medicare Advantage plans.

Accessing Wellness Programs

To determine if your specific Medicare plan offers a gym membership or wellness benefit, reviewing your plan’s official documents is a first step. Your “Summary of Benefits” or “Evidence of Coverage” (EOC) document provides detailed information about what your plan covers, including any extra benefits.

You can also contact your Medicare Advantage or Medigap plan provider directly. Their customer service can confirm whether your plan includes fitness benefits and explain how to utilize them. Many plans have online portals or phone numbers listed on your member ID card for inquiries.

For specific wellness programs like SilverSneakers or Renew Active, you can visit their respective websites. These sites have a locator tool where you can enter your zip code or plan information to find participating gyms and fitness centers in your area. They can also provide details on eligibility and how to activate your membership.