Original Medicare consists of two parts: Part A, which covers inpatient hospital services, and Part B, which covers outpatient medical care and certain preventive services.
While it might seem that fitness programs could be considered preventive care, Part B’s coverage is limited to programs supporting physical health for medical conditions. These programs include:
- Occupational therapy
- Physical therapy
- Speech therapy
- Cardiac rehabilitation
- Chiropractic care
- Durable medical equipment
Without a medical diagnosis requiring physical therapy or rehabilitation, if you only have original Medicare, you’ll have to cover the full cost of fitness center or gym memberships out of your own pocket.
However, you can choose optional Medicare plans like Medicare Part C (Medicare Advantage) or Medicare supplement insurance (Medigap). These plans might cover fitness center and gym fees, with coverage varying based on plan type, location, and the amount you’re willing to pay for your plan.
How to Obtain a Gym Membership Through Medicare Advantage Plan
Medicare Advantage (Part C) is an optional plan provided by private insurance companies. These plans are obligated to cover at least as much as original Medicare in terms of inpatient, outpatient, and preventive care services.
Additionally, most plans offer extra services beyond original Medicare. The additional benefits depend on factors such as:
- The insurance provider
- Your location
- The services you choose to include in your plan
- How much you can pay for coverage
What is SilverSneakers?
SilverSneakers is a fitness program designed for adults aged 65 and older. While this program isn’t covered under original Medicare, many Medicare Advantage plans include SilverSneakers or similar fitness programs in their coverage.
SilverSneakers provides more than just gym memberships, offering:
- Wide availability at over 17,000 participating fitness centers nationwide.
- Tailored fitness classes for older adults, including chair exercises, water exercise, yoga, tai chi, circuit training, and weight training.
- SilverSneakers FLEX classes, offering fitness programs outside of traditional gyms, such as walking programs, community center classes, park programs, and more.
- Online resources, including a library of fitness materials, nutrition information, on-demand classes, and workout videos. The SilverSneakers app, “SilverSneakers GO,” helps track fitness, nutrition, and health information.
SilverSneakers is often included at no extra cost as part of many Medicare Advantage plans. Eligibility criteria vary, so you can check your eligibility through your plan provider or on the SilverSneakers website.
Are Other Fitness Programs Available?
Aside from SilverSneakers, many Medicare Advantage plans offer additional fitness options, such as:
- Renew Active by United Healthcare, which includes a gym membership, an online brain health program, and access to local health and wellness events.
- Silver&Fit, offering online or in-person fitness services at over 14,000 locations nationwide.
- Blue Cross Blue Shield, which provides some Medicare Advantage members with $150 per year toward fitness center memberships, with certain restrictions.
These programs may offer similar services to SilverSneakers or provide complementary support, including wellness resources and nutritional counseling. Most Medicare Advantage plans include these services at no extra cost beyond the chosen plan’s expense. If you’re interested in fitness services, inquire about coverage when selecting your Medicare Advantage plan.
Medigap Coverage for Gym Memberships
While Medicare Advantage plans often cover gym memberships and fitness program costs, Medigap plans do so less frequently.
Typically, Medigap plans focus more on covering your portion of original Medicare services rather than additional services like fitness programs. However, some plans may offer options for fitness program coverage.
If you’re seeking coverage for fitness memberships, it’s essential to carefully compare Medigap plans before making a decision.
Other Healthy Lifestyle Benefits Offered by Medicare
Beyond coverage for fitness programs or gym memberships, Medicare provides a range of services promoting overall wellness. Both Original Medicare and Medicare Advantage plans cover various wellness services, either considered medically necessary or as a supplemental service under an Advantage plan. These services include:
- Diabetes care
- Heart health and cholesterol programs
- Preventive health screenings
- Mental health visits
- Addiction and substance use disorder services
- Smoking cessation programs
- Nutritional counseling
- Dental care
- Weight loss surgery
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