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Does health insurance pay for a gym membership?

health insurance gym membership Obesity is the biggest cost factor in American healthcare, adding $190 billion to the country’s annual health care bill.

Regular exercise can go a long way towards combatting obesity, and even 30 minutes once or twice a week can make a difference. The 2009 Gallup-Healthways Well-Being Index found that people who did not exercise had a 35 percent likelihood of being obese; for those who exercised 30 minutes one or two days a week, that likelihood dropped to 28 percent.

Joining a gym can help you build up a regular exercise routine and lose weight, leading to lower health care expenses. But will your health insurance plan cover your gym membership? In some cases, yes—at least in part.

Health insurance coverage for gym membership

One health care provider that operates in New England, Harvard Pilgrim Health Care, offers its policyholders up to $150 in reimbursement each year towards membership fees if they have been members of a gym for at least four months. There are some limitations on coverage, however: The gym must be equipped with strength-training and cardiovascular equipment such as treadmills, elliptical trainers and weight machines; it is not valid for yoga or Pilates studios, pool-only facilities or personal training.

Aetna offers gym membership discounts with most of its plans, says Ethan Slavin, a communications officer at Aetna. This year, Aetna also launched a fitness reimbursement program, which is open to a number of employer-sponsored health care plans. In addition to gym memberships, plan members can receive reimbursement for purchasing at-home exercise equipment, group classes and wellness counseling. Employers are able to customize the program and decide how much money their employees are eligible to be reimbursed for their fitness-related expenses.

For employers, such programs are a win-win. “As part of a comprehensive wellness strategy, this program can help employers lower their health care costs and create a more productive and engaged workforce,” says Susan Kosman, Aetna’s chief nursing officer. “Offering this program is a tangible way that employers can show their employees that they are committed to their well-being.”

If you’re 65 or older, you also may be eligible for the Silver Sneakers program through your Medicare plan or supplement. Silver Sneakers is a nationwide health program for senior citizens that provides free gym membership and wellness counseling at participating gyms to more than 1 million enrolled members.

Gym benefits help health insurance providers

Covering gym membership is a plus for health insurance providers, too: By advertising the perk in their marketing materials, insurance providers are likely to attract a healthier segment of the population, which will lead to lower claim rates.

According to a study, published in the New England Journal of Medicine, members of a Medicare Advantage plan that offered fitness benefits were over 6 percent more likely to self-report as being in “excellent” or “very good” health compared to those who didn’t.

And, by encouraging policyholders to exercise more frequently, insurance providers are likely to reduce such members’ claim frequency for illnesses and chronic conditions, lowering health care costs. An analysis performed by the Institute for the Study of Aging found that Silver Sneakers members who went to the gym an average of 1.4 times per week each saved their insurance providers about $1,018 per year compared to a control group who did not participate in the program.

3 ways to save money on fitness

Despite the obvious advantages of covering gym-related expenses in health insurance plans, not all providers have jumped on board yet. However, there are a number of other options for factoring a gym membership into a limited budget:

1. Consider a FSA account.

A flexible spending account, known as an FSA, allows you to divert up to $2,500 per year of pre-tax income to pay for a wide variety of health-related services that may not be covered under your health insurance plan, including chiropractic services, vision services and prescription medications. FSA funds can pay for fitness programs, provided that your doctor has written a “letter of medical necessity” that explains what condition the membership will help treat.

You may be able to open an FSA account through your employer; check in with your human resources department to find out if you are eligible. Unfortunately, if you’re self-employed, you’re not eligible for an FSA.

2. Find out about employer wellness program options.

Even if your health insurance provider doesn’t directly reimburse fitness-related expenses, your employer may. Many larger employers offer discounted gym membership and other fitness-related benefits as part of their employee wellness programs: Check in with your company’s human resources department, or search for your company name on GlobalFit.com to find out if your company has a discount program.

3. Seek financial assistance or special offers.

Although most gyms are for-profit entities, some non-profit health clubs, including YMCAs and Jewish Community Centers, provide sliding scale membership options for lower-income individuals. You can also find many low-cost deals for gym memberships or fitness classes by signing up for “daily deals” newsletters like Groupon. It’s also worth paying attention to your local gyms’ websites so that you are aware of other special promotions.

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