Unfortunately, Original Medicare does not typically cover gym memberships. However, some Medicare Advantage plans may offer coverage for fitness-related expenses.

Original Medicare and fitness benefits: what may be covered?

Original Medicare (consisting of Parts A and B), does not cover gym memberships. You’ll be responsible for covering the entire cost of your gym or fitness center membership when enrolled in Original Medicare.

However, it’s important to note that Original Medicare does provide coverage for some fitness benefits in specific situations.

For instance, Original Medicare covers:

• Medically necessary occupational therapy or physical therapy for injuries or illnesses.
• Group sessions focused on preventing diabetes and programs to assist with diabetes management are covered by Medicare.
• Medicare offers nutrition therapy as a free preventive benefit for individuals with diabetes or kidney disease.
• Medicare Part B covers weight-loss counseling for individuals with a BMI of 30 or higher, including obesity screening, dietary assessment, and behavioral therapy.
• Medicare Part B also covers yearly “Wellness” visits with your healthcare provider. During this visit, you can discuss your overall health and receive advice on preventive care, which may include exercise recommendations.

If you don’t have a doctor’s note saying you need rehab or physical therapy, you’ll have to dig into your own wallet to cover the whole bill for your gym membership with Original Medicare.

However, there may be options to obtain coverage for gym memberships or fitness programs through Medicare Advantage Plans or Medicare Supplement Insurance (Medigap) plans. If you’ve got one of these plans, just check in with your plan provider to see what they’re offering for gym memberships and fitness perks.

Medicare Advantage and gym membership coverage

Medicare Advantage or Medicare Part C plans are offered by private insurance companies approved by Medicare. These plans often provide additional benefits that may include gym memberships or fitness programs.

Almost all (99%) of individual Medicare Advantage plans offer fitness benefits for their enrollees. Some plans even have fitness programs like SilverSneakers and Silver & Fit, giving access to over 15,000 fitness and community locations nationwide.

Therefore, if having Medicare and gym membership is a priority for you, we recommend you carefully compare different Medicare Advantage Plans available in your area and choose one that includes your preferred fitness programs.

What additional fitness programs are available with Medicare Advantage?

Many Medicare Advantage plans cover additional fitness programs like:

• SilverSneakers: Gym membership + in-person and online fitness programs
• Silver & Fit: Online or in-person fitness classes across 14,000+ locations nationwide
• Mutually Well: Gym membership + discounts on wellness programs
• Renew Active: Gym membership + online brain health program

Note: The list is not limited to just these fitness programs. Each Medicare Advantage plan comes with its own added perks and fitness benefits. Also, you can only use your gym membership at participating gyms and fitness centers that are part of the fitness program under your Medicare Advantage plan.

Does Medicare cover YMCA membership?

Original Medicare (Part A and Part B) does not cover gym memberships or any other fitness programs, including YMCA memberships.

However, if you have a Medicare Advantage plan, you may be able to receive direct benefits for YMCA membership or receive reimbursement for out-of-pocket expenses for YMCA membership or services.

What is SilverSneakers program in a Medicare Advantage plan?

The SilverSneakers program, available through many Medicare Advantage Plans, offers seniors a fantastic way to get fitness benefits and stay connected. Here’s why it’s great:

• Community & Support: It fosters social connections, reducing isolation.
• Variety: Diverse fitness classes cater to various interests.
• 17,000+ Facilities: Access to a vast network of gyms and centers.
• Personalized Plans: Tailored fitness guidance for members.
• No Extra Cost: Often included with your Medicare Advantage Plan.

SilverSneakers is a convenient, cost-effective way for seniors to stay active and enjoy the company of peers.

How to get gym membership with Medicare Advantage?

The specific Medicare gym membership benefits offered by the Advantage plans can vary. Some plans may provide access to a specific network of fitness centers or gyms, while others may offer reimbursement for a portion of the gym membership fees. 

If you’re considering a Medicare Advantage plan with a gym membership benefit, here are a few steps you can take:

1. Research Medicare Advantage plans

Look for plans available in your area and compare their benefits, including gym membership options. You can visit the Medicare website (medicare.gov) or contact Medicare directly for information on available plans.

2. Review plan documents

Once you’ve identified a few Medicare Advantage plans that interest you, review their plan documents, such as the Summary of Benefits and Evidence of Coverage. These documents outline the specific benefits and coverage details, including any gym membership benefits.

3. Check the network

If a plan offers gym membership, make sure to check if there are participating fitness centers or gyms in your area. You’ll want to ensure that there are convenient options for you to use the benefit.

4. Understand any limitations or requirements

Some Medicare Advantage plans with gym membership benefits may have certain limitations or requirements. For example, they may specify a maximum reimbursement amount or require you to visit the gym a certain number of times per month. Be sure to understand and consider these factors.

5. Enroll in a plan

If you find a Medicare Advantage plan that suits your needs and includes a gym membership benefit, you can enroll during the appropriate enrollment period. This typically includes the Annual Enrollment Period (October 15 to December 7) or a Special Enrollment Period if you qualify, assuming your Initial Enrollment Period has passed

You can use a plan finder like Hella’s Personal Shopper and in your Medicare Needs Profile go to Extra Benefits, choose Fitness and Go to Plans and you’ll get a list of MA plans that include fitness benefits.

Do Medicare Supplement plans cover gym memberships?

Medicare Supplement Insurance plans, also known as Medigap plans, do not typically cover gym memberships or fitness programs. Medigap plans are designed to work alongside Original Medicare (Parts A and B) and help cover certain out-of-pocket costs such as deductibles, copayments, and coinsurance.

Stay active, Medicare-style

The question of whether Medicare covers gym memberships depends on the specific type of Medicare plan you have. It’s a bit of a mixed bag.

Original Medicare (Part A and Part B) doesn’t typically cover gym memberships. However, some Medicare Advantage (Part C) plans may offer gym membership benefits as part of their extra coverage.

But remember that each plan can have its own set of rules and benefits. So, grab a cup of coffee, sit back, and review the plan documents carefully. Look for keywords like “gym membership” or “fitness program” in the Summary of Benefits and Evidence of Coverage.

Just remember, the availability of gym membership coverage can change from year to year, and different insurance companies may offer different options. To get the most accurate and up-to-date information, it’s a good idea to reach out to the insurance company or use tools like Hella Helath’s Personal Shopper to look for current plans. Our Medicare Plan Shopper will guide you through the maze of Medicare gym programs and help you find one that suits your fitness goals. Stay active and keep exploring the options available to you!

Article updated on November 22, 2023.