Healthy living usually includes a combination of things like regular health checkups with the appropriate medical and dental professionals, eating nutritious foods and regular physical movement to encourage a healthy body as we age. While those who depend on Medicare can always choose to eat healthy foods regularly and plan visits to the doctor or dentist, paying for a fitness program or gym membership may seem to be financially out of reach for many. But can someone get Medicare coverage for fitness programs, placing this vital piece of healthy living within reach of those who rely on Medicare for their health care needs? Let’s take a look at what the different types of Medicare cover for those that desire healthy living options that include gym or fitness club memberships.
Original Medicare
Simply put, the Original Medicare program does not provide coverage for gym memberships or other fitness programs under Part A (hospital insurance) or Part B (medical insurance). Under Original Medicare, participants pay 100% of non-covered services like memberships in a fitness program. But this program does allow for extra coverage to be procured like Medicare Advantage Plans Medicare Supplement Insurance (Medigap), as well as other Medicare health plans, some of which do provide health club membership coverage options as well as other fitness options that may be tied to treatments. This coverage is connected to prescribed treatments and may include physical therapy, occupational therapy, as well as other nutritional therapy treatments.
Medicare Advantage (Part C)
This third option to Original Medicare, called the Advantage plan, may provide fitness center or program plans. The Advantage program is private insurance coverage, not coverage by the governmental plans (Parts A and B), so additional healthy living coverage can be included in these plans. Some Advantage plans cover fitness memberships like the Silver Sneakers program, a fitness program to keep older adults healthy that is tied to specific gyms and fitness centers across the nation.
What Types of Fitness Memberships Could an Advantage Plan Offer?
Since the Part C plans are administered by private insurance companies, their offerings can vary widely. However, since these plans all cater to older adults, the fitness center benefits all revolve around gyms or other businesses that serve seniors. An Advantage plan may offer gym memberships at places like YMCAs, local gyms or fitness centers as well as community fitness centers notes ClearMatch Medicare. Each plan under the Part C Medicare Advantage program has specific options available to members, but many do offer a physical fitness option. Two of the most commonly supported health and fitness programs supported by Medicare Advantage (MA) insurers are SilverSneakers and Silver & Fit:
- SilverSneakers is connected to over 14,000 fitness centers and the program includes nearly 50 different fitness programs and activities for seniors to choose from including a workout-from-home option.
- Silver & Fit is a fitness program that is connected to over 18.000 gyms, provides an online option for at-home fitness but also charges a nominal monthly fee for participation in this robust healthy living program for seniors.
Supplement Medicare Insurance (Medigap)
Another extra Medicare coverage, Medigap is private insurance that also provides the potential for health club or fitness center coverage. Popular Medigap fitness plans include SilverSneakers as well as Silver & Fit options, both offering comprehensive opportunities for seniors to attend local gyms or fitness centers regularly. But Medigap also has two other options available for seniors who wish to have fitness coverage with their Medicare: United HealthCare’s Renew Active program and Aetna’s Senior PHIT program.
- The Renew Active plan is available through Medigap and MA coverage through insurance by United HealthCare. This option provides participating gym memberships, local wellness and health events as well as online brain health programs offered to members.
- The Senior PHIT program from Aetna is the insurance company’s Personal Health Improvement Training program for seniors. This coverage, through some MA plans Aetna offers, gives members access to many participating health clubs and gyms as well as educational and wellness tools accessible online and in person.
Fitness Care for Seniors with Medicare
While Original Medicare does support healthy lifestyles for seniors, including comprehensive services like regular doctor visits as well as nutritional and mental health wellness, it does not provide fitness memberships that are not directly tied to physical or occupational therapy. However, Part C Medicare Advantage and Medigap plans both offer seniors multiple options of extra insurance coverage from private companies that do allow for gym or fitness club memberships as well as many other supportive services like online or at-home fitness plans. Popular programs like SilverSneakers and Silver & Fit connect active seniors with fitness options, both accessible through MA, Medigap, or both. Other options support senior fitness and health, like the insurance-based offerings like Renew Active and Senior PHIT, allowing seniors to utilize gym memberships along with a host of other healthy-living services that encourage fitness later in life. For anyone who is using Medicare, the opportunity to attend a gym or fitness center is available without a treatment prescription for those who purchase the additional Part C Medicare Advantage or Medigap coverage.
