One question that often comes my way when it comes to Health Insurance is whether or not fitness is a covered expense. Whether it is a gym membership or a personal trainer, the answer really depends on the circumstances or the type of health insurance you have.
When it comes to a personal and/or fitness trainer, the exercise must be medically necessary for a health condition for it to be considered a covered expense. The majority of the time that it is a covered expense is often after physical therapy concludes, but you still need some training before resuming full activities. Your doctor will have to request the personal training and even then, the personal trainer may have to have specific credentials before it can be covered.
If you use a health savings account, you can use that account to help cover the expense of a personal trainer without having to worry about putting it through your insurance. A Health Savings Account is a way to help put money away into a separate account tax free. The money that is put into the account can be used for health expenses such as co-pays, prescriptions, dental, and vision. There are some rules and regulations regarding Health Savings Accounts that I will go into next week.
When it comes to gym memberships, there is some good news. Many health insurance plans especially when you get it through an employer will have discounts for gym memberships. Some employers will offer reimbursements for gym memberships. The belief here is that when you take better care of yourself, your health expenses will be lower which is good news for you, your employer, and the insurance company.
When it comes to Medicare, Medicare Part A and Medicare Part B do not cover gym memberships, however some Medicare Supplemental Plans as well as some Medicare Advantage Plans do. Some plans will only offer a discount for certain gym facilities and if a gym facility is not located in your area, you may be eligible for a home exercise kit.
Although you may not have the coverage you hope for with your health insurance plan regarding gym memberships, it’s important to research what your plan does cover. Some plans may offer discounts on massages, healthy meal plans, and even nutrition programs. All of this is designed to to help you take action to improve your health. There may even be some coverage for that personal trainer or coach you were looking into to help with weight management.
At Balanced Care, we believe in providing education that helps you to help yourself. Healthy habits such as exercise help to prevent certain health conditions such as heart disease, stroke, and diabetes. Those habits can mean the difference between being sick or healthy.
Making smart choices when it comes to diet and exercise and making just one small change for a healthier lifestyle could mean lower out of pocket costs for your healthcare.
Terri Trepanier is the owner of Balanced Care Health and Supplemental Insurance and a licensed insurance consultant and broker with Associated Brokers. Licensed in both Maine and NH, her specialty is working with small businesses, individuals, and families with their health and life insurance needs. She is certified to offer health plans both on and off the exchange and is contracted with every health insurance company that offers plans in both New Hampshire and Maine. Her other passion is assisting Medicare beneficiaries with their Medicare Supplemental, Medicare Part D Prescription Drug Plans, and Medicare Advantage plans. Terri has seen firsthand the importance of insurance products and how they help families. Her goal with Balanced Care is to “Insure Security and Peace of Mind One Family at a Time”.