Orlando Harmon
Medicare is the U.S. health insurance program for people aged 65 and older. Original Medicare does not cover gym or fitness centre memberships. However, private Medicare plans, like Medicare Advantage or Medigap, might cover gym memberships and other fitness services. Medicare Advantage plans, also known as Part C or MA plans, are sometimes referred to as all-in-one packages for Original Medicare services. They cover Part A and Part B, and most include Part D (prescription drug coverage) as well. Some Medicare Advantage plans also offer health and wellness benefits that aren’t available with Original Medicare.
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What You'll Learn
Medicare Advantage plans
Medicare Advantage, also known as Medicare Part C, is an optional plan offered by private insurance companies. These plans must cover at least as much as Original Medicare in terms of inpatient, outpatient, and preventive care services. Most plans may also offer additional services beyond Original Medicare.
Most Medicare Advantage plans are either HMOs, which generally cover only care provided by in-network doctors, hospitals, and other health providers, or PPOs, which also offer access to out-of-network providers but at a higher cost than in-network providers. PPOs can be local or regional. Local plans serve one or multiple counties, while regional plans serve a single state or group of states.
While Medicare Advantage is a good choice for some people, it's not right for everyone. There are some potential downsides to Medicare Advantage plans. Firstly, there may be restrictions on your ability to switch back to Original Medicare with a Medicare Supplement Insurance, or Medigap, policy. Secondly, you may have to get approval from your Medicare Advantage plan to have certain tests or procedures, which can delay care. Thirdly, there is a chance that your Medicare Advantage plan could end coverage, either by the insurer or the network, and its included medical providers. Finally, some people have expressed concerns that insurance companies dangle "free" gym memberships and other perks in front of customers without informing them of the limitations of the plan should they need serious care.
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SilverSneakers
The program can be accessed through insurance companies that handle Medicare, and it is included in some Aetna Medicare Advantage plans. It is important to note that SilverSneakers is not available with all Medicare plans, and those interested should review their coverage to see if it is included.
While SilverSneakers can provide a great benefit to those looking to improve their health, it is important to be aware of the potential limitations of Medicare Advantage plans. Some have expressed concerns about the limitations of these plans when it comes to needing serious medical care, and it is essential to carefully review the terms and conditions before enrolling.
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Medigap plans
Medicare is the US health insurance program for people aged 65 and over. Original Medicare does not cover the cost of gym memberships or fitness programs. However, private Medicare plans, like Medicare Advantage or Medigap, might cover gym memberships and other fitness services.
Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare. Generally, you must have Original Medicare – Part A (Hospital Insurance) and Part B (Medical Insurance) – to buy a Medigap policy. Medigap plans generally help cover your share of costs for services that are covered by Original Medicare (Part A and Part B). The benefits are different for each plan, so you can buy the one that meets your needs.
Medigap insurance typically covers the 20% that is your responsibility to pay, along with some other healthcare costs. For example, some Medigap policies cover services that Original Medicare doesn't cover, like emergency medical care when you travel outside the US (foreign travel emergency care). Medigap plans generally don't cover prescription drug coverage.
You can buy any Medigap plan available in your state, and insurers can’t turn you down or charge you more due to pre-existing health conditions during the six months after you initially sign up for Medicare Part B. After that, you could be denied or charged higher monthly premiums. Connecticut and New York let Medicare beneficiaries buy a Medigap plan at any time without being denied. Other states let you switch plans at designated times.
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Medicare Supplement plans
Medicare Supplement Insurance, also known as Medigap, is extra insurance that you can purchase from a private health insurance company. This insurance helps to cover some of the costs that Original Medicare Parts A and B do not, such as coinsurance, copayments, or deductibles. It is important to note that Original Medicare does not typically cover gym or fitness centre memberships. However, Medicare Supplement plans or Medigap insurance may provide coverage for gym memberships and other fitness services.
Medigap plans are available to individuals aged 65 and older enrolled in Medicare Parts A and B, and in certain states, to those under 65 who are eligible for Medicare due to disability or End Stage Renal Disease. It is worth noting that you generally must have Original Medicare (Part A and Part B) to buy a Medigap policy.
Medigap plans vary, and the benefits you receive depend on the specific plan you choose. Plans A through G typically offer benefits at higher premiums with limited out-of-pocket costs compared to Plans K through N. Plans K through N, on the other hand, are cost-sharing plans that offer similar benefits but with lower premiums and higher out-of-pocket costs.
It is important to carefully review the details of any Medicare Supplement plan you are considering, as coverage may be limited to Medicare-eligible expenses, and exclusions and limitations may apply. Additionally, the availability and specifics of these plans may vary depending on your state and your specific circumstances.
While Medicare Supplement plans can provide valuable additional coverage, it is important to carefully consider your own needs and budget before purchasing any insurance plan.
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Original Medicare
If you opt for a Medicare Advantage plan through a private insurer instead of Original Medicare, coverage for gym memberships and fitness centers is available. Medicare Advantage plans must offer at least the same amount of coverage as Original Medicare, and they may also offer additional benefits, which could include gym memberships. Almost all Medicare Advantage members (98%) were in plans that covered some fitness benefits in 2022. Medicare Advantage plans also offer free gym memberships with access to a nationwide network of health clubs and exercise locations, personalized fitness plans, and on-demand workout videos.
Medicare Supplement insurance plans (Medigap) do not typically include gym memberships. However, gym memberships and fitness programs may be part of the extra coverage offered by some Medigap plans.
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Frequently asked questions
No, Original Medicare does not cover gym memberships or fitness programs.
Medicare Advantage plans, also known as Part C or MA plans, may cover gym memberships and fitness programs. Medicare Supplement Insurance (Medigap) plans may also cover gym memberships, but this is less common.
If you have a Medicare Advantage or Medigap plan, call your plan to see if it covers gym memberships or fitness programs.
