Friday, May 17, 2024

Does Original Medicare Cover Silver Sneakers

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Its in everyones best interests for insurance plans to offer fitness benefits. According to the National Institutes of Health, exercise protects against heart disease, stroke, diabetes, and can even help prevent some forms of cancer. It also improves mental health and contributes to a better quality of life. For these reasons, its not surprising that a Centers for Disease Control and Prevention study showed almost one-half of all U.S. workplaces include fitness benefits in their health plans.

SilverSneakers is a subsidiary of Tivity Health, the company behind Nutrisystem, Prime Fitness, and Wisely Well brands. Although its the largest company offering Medicare fitness programs, it competes against programs such as Active & Fit Direct and Silver & Fit.

Insurers that want to offer fitness benefits choose the program that makes the most sense for their members. Some insurance companies develop their own fitness networks. For instance, UnitedHealthcare recently scaled back its participation in SilverSneakers in favor of Renew Active, a new fitness program created exclusively for UHC Medicare Advantage members.

If your Medicare plan doesnt offer SilverSneakers, it may offer one of the other fitness programs. You may even get fitness benefits with your life insurance policy: For example, John Hancocks Vitality Program rewards policyholders who participate in an active lifestyle.

Which Insurance Plans Include Silver Sneakers

If you are looking forward to starting a steady, exciting, and rewarding exercise program, Silver Sneakers may be a suitable option for you. Getting active and setting up an exercise regime is important to keeping good health and leading a well-balanced lifestyle. Some insurance plans even offer coverage for the Silver Sneakers program. If youre wondering how to enjoy the benefits of the extensive program and what your insurance offers, keep reading.

What Insurance Plans Include Silversneakers Coverage

Key Takeaways:
  • Original Medicare does not cover SilverSneakers. However, many Medicare Advantage and Medicare Supplement plans do offer this benefit
  • SilverSneakers coverage availability varies based on your state and which insurance provider you use
  • Most Medicare insurance carriers offer SilverSneakers membership as a benefit. Well outline four options you can take advantage of
  • SilverSneakers offers a range of online and in-person programming to seniors seeking to exercise with a community of peers. Well go over some of the key benefits of the program

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Can I Get Silver Sneakers Without Medicare

Unfortunately, Original Medicare does not offer or include SilverSneakers. Additionally, you can t buy a SilverSneakers membership outside of a health insurance plan from a private insurance companyyou can only enroll through a qualifying MA or Medicare Supplement plan.

Medicare Part B Covers Physical And Occupational Therapy

Medicare Wellness and SilverSneakers Programs

Medicare Part B helps pay for physical and occupational therapy deemed medically necessary by your doctor. He or she must prescribe and regularly review the therapy, which must be provided by a Medicare-certified therapist on an outpatient basis.

Part B pays 80 percent of the Medicare-approved amount, leaving you responsible for the remaining 20 percent. In addition, the Part B deductible applies. All Part B beneficiaries are covered assuming the services are medically reasonable and necessary.

Always talk to your provider to determine your costs as well as why they recommended the services. Medicare doesn’t cover a cost just because your doctor recommended it. The service must be deemed medically necessary.

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Aetna Medicare Advantage Plan Benefits Focus On Your Well

Most Medicare Advantage plans from Aetna offer a wide range of benefits in addition to SilverSneakers membership. These benefits are designed to help take care of your total health.

Many Aetna Medicare Advantage plans also include:

  • Prescription drug coverage
  • Dental, vision and hearing benefits
  • Non-emergency transportation coverage for things like doctors office visits or trips to the pharmacy
  • Home meal delivery services after a hospital stay
  • Over-the-counter benefit that allows you to get certain items like vitamins and cold medicine at no additional cost
  • Prescription home delivery for plans that include prescription drug coverage
  • 24/7 nurse hotline
  • No-added-cost annual flu shots

Plan availability and features can vary by service area. Be sure to ask a licensed insurance agent or check your plans Evidence of Coverage to see what benefits are offered with your plan.

Renew Active Vs Silver Sneakers


  • Further Reading:
  • Does it sometimes seem like Medicare and Insurance companies are trying to make things as complicated as they possibly can? Just when you think you have Medicare Advantage down, something else comes up! For example: Renew Active vs Silver Sneakers.

    Not so very long ago, there was one main senior fitness program when you joined a Medicare Advantage Plan: SilverSneakers®. Then, in January 2019, one carrier dropped SilverSneakers and replaced it with Renew Active. Many people were concerned when this first happened. However, it now seems like Renew Active is a reasonable replacement.

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    Does Medicare Pay For At

    One of the most burning questions eligible Medicare beneficiaries are asking today is whether or not Medicare will pay for at-home COVID tests, and rightly so. While not every Medicare beneficiary is home-bound, many are. Because the pandemic continues, it is crucial that we remain aware of changes to testing and treatment.

    The convenience of at-home testing should be a noteworthy option worth exploring for those needing COVID or other testing, especially for those 65 years or older, and/or are at high-risk with health-related concerns. At-home COVID testing through Original Medicare coverage is not available at this time. What that means is Original Medicare will not cover or reimburse the purchase of an at-home COVID test from local retailers such as drug stores, grocery stores and the like.

    Community health centers and Medicare-certified health clinics that offer at-home COVID tests free of charge. Thats a great savings perk since COVID tests can cost anywhere between $36- $180 dollars per test, plus any fees that may be included, or are extra for special medical circumstances.

    If administering an at-home test requires the assistance of a medical professional-aide deemed necessary by a physician, Medicare will pay for such skilled nursing or therapeutic assistance at home.

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    When Can I Enroll In Silversneakers Through A Humana Medicare Plan

    Silver Sneakers and Medicare – Is it covered by your Medicare Plan?

    You may have up to three opportunities to enroll in a Humana Medicare Advantage plan that offers SilverSneakers.

    • Your first opportunity to enroll in a Medicare Advantage plan is typically during your Medicare Initial Enrollment Period , which begins three months before your 65th birthday, includes the month of your birthday and lasts for another three months after that, for a total of seven months.
    • You may also be able to enroll in a Humana Medicare Advantage plan or switch from one Medicare Advantage plan to another during the fall Medicare Open Enrollment Period , which lasts from October 15 to December 7 each year.
    • Depending on your individual circumstances, you may also have the opportunity to enroll in a Medicare Advantage plan if you lose your current coverage through no fault of your own, move to a new area or experience any other life events that may qualify you for a Special Enrollment Period .

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    Find Out If Youre Eligible For Silversneakers

    What are the SilverSneakers eligibility requirements?

    In order to be eligible for the SilverSneakers Fitness program, you must be:

    • Living in the U.S.
    • Enrolled in a private Medicare plan that offers the SilverSneakers benefit

    To be eligible for SilverSneakers, you must join a participating Medicare Advantage plan or a Medicare Supplement Insurance plan.

    If you are already enrolled in one of those types of private insurance plans, you can visit to see if your current plan offers the program.

    Which Is Better Medicare Advantage Or Supplements

    Its important to know that Medicare Advantage plans are much different than Medicare supplement plans and you cannot have both at the same time. While Silver Sneakers is a nice perk, it may not be reason enough to choose one policy over the other. Its a good idea to discuss the differences with an independent agent before enrolling.

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    How To Join The Program

    The best way to take advantage of this program is through a Medicare Advantage plan that includes the SilverSneakers® benefit. The good news is that we have thousands and thousands of licensed agents who can guide you through the process of selecting a Medicare Advantage plan that includes the SilverSneakers® benefit.

    You should know that Medicare Advantage plans have the ability to change their benefits every year, which is why its a good idea to have a licensed agent that you can turn to at least once a year to review your coverage and make sure that youre getting everything you need. To set up an appointment, or call 833-438-3676.

    Which Plans Include Silver Sneakers

    Does TriCare for Life include Silver Sneakers in Texas ...

    As indicated, some of the Medigap and Medicare Advantage marketers include Sneakers in your coverage when you sign up through them. The list of participating marketers is constantly changing but here are a few:

    • United Healthcare Medicare supplement through AARP

    You can review the current list of marketers by usingthis link.

    As best we can tell you cannot sign up direct with Silver Sneakers for a membership.

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    What You Pay With Tricare For Life

    You donât pay any enrollment fees, but you must pay Medicare Part B monthly premiums. Your Part B premium is based on your income.

    For more information about Medicare Part B visit our Medicare page.

    • Services covered by both Medicare and Tricare youâll pay nothing out of pocket.

    • Medical procedures covered by Medicare only you will be responsible for Medicare deductibles and cost shares

    • Medical procedures covered by Tricare only you are responsible for any TFL deductibles and cost shares

    • Medical procedures not covered by Tricare or Medicare you are responsible for the entire amount.

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    How To Find Out If You Qualify

    Want to know if youre qualified for a SilverSneakers membership? Its easy to find out simply contact your health insurance provider directly and ask if you are eligible. There are more than 60 health plans that provide memberships for their beneficiaries.

    You also can visit the SilverSneakers website and use their eligibility checker tool to find out if you qualify for a membership. Once youve verified your eligibility, all you need to do is request a membership card on the SilverSneakers website and print it out.

    The SilverSneakers website also has a locator tool to help you find participating SilverSneakers gyms in your area. You can even filter your search so that it includes only gyms that offer specific classes or have certain types of equipment. For example, if you want to maintain your weekly workout regiment or participate in classes while youre traveling or on vacation, you can easily lookup the closest gym that has what you need.

    The SilverSneakers program is great way to gain access to local gyms and physical fitness courses, and it may be included in your existing Medicare coverage. Take the next step toward joining a community of active seniors and find out if youre available for a free membership.

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    Types Of Plans With Silversneakers

    You can find the SilverSneakers® benefit inside a Medicare Advantage or Medicare Supplement plan. Medicare Advantage plans are offered by private insurance companies but approved by Medicare. That means that they cover everything that Medicare covers, but can also add additional benefits .

    On occasion, you may also find fitness programs within a Medigap, or Medicare Supplement plan. Medigap plans are also offered by private insurance companies but most of the time, they do not add coverage in the same way that Medicare Advantage plans do. In most cases, the extra coverage that Medigap plans provide relates more to coverage for your deductibles, copayments, and coinsurance. However, on occasion, you may find a Medigap plan that includes a gym membership.

    Even if your plan does not include this program, it may include another Medicare fitness program called Silver & Fit®.

    How Does Silver Sneakers Work

    Medicare Supplement Plan F – Does It Include A Gym Membership?

    Silver Sneakers eligibility is based around if you are a member in one of their more than 60 participating Medicare Advantage plans across the United States. If you are a member in a participating Medicare Advantage plan you are eligible for a free Silver Sneakers gym membership. Its that easy.

    How it works is simple, too.

  • Meet Silver Sneakers eligibility requirements by enrolling in a participating Medicare plan
  • Enter your information on the Silver Sneakers website.
  • Get a copy of your Silver Sneakers card
  • Google Silver Sneakers near me
  • Take your card to the Silver Sneakers gym of your choice
  • Start exercising, staying healthy and saving money!
  • Can anyone join SilverSneakers?

    Silver Sneakers eligibility requirements are solely based around those who enroll in Silver Sneaker partnered Medicare plans. This is one of the benefits of using a Medicare Advantage plan over a Medicare Supplement as most Medicare Supplements do not include Silver Sneakers.

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    Silver Sneakers Vs Active And Fit Direct Program

    When it comes to fitness programs, beneficiaries have plenty of options. SilverSneakers and Active & Fit Direct are both fitness programs that accommodate seniors.

    The SilverSneakers program allows beneficiaries to have free access to gyms nationwide.

    Members may have access to full use of gym equipment and benefits, including weights, cardio machines, saunas, pools, and hot tubs.

    SilverSneakers offers fitness classes such as yoga, cardio-fit, circuit training, and water aerobics.

    The Active and Fit program allows members to choose from over 9,000 facilities across the nation.

    The program offers an online directory map and locator for fitness facilities. Also, you can switch fitness centers to make sure you find the right fit.

    The Active& Fit Direct Program also offers online wellness tracking, which comes from a variety of wearable fitness devices. However, the program is only for individual or employer group members.

    Active& Fit Direct continues to expand its growing network to meet the clients needs. This year there was an addition over 1200 facilities, including large chains, independent and local gyms.

    Members can search the online directory for some of the nations finest fitness centers in their area.

    Silversneakers & Silver Fit

    SilverSneakers is for seniors with select Medicare supplemental insurance policies. This unique program allows older adults to take charge of their health and maintain an active, independent lifestyle. If an individual has this option on their health insurance plan they will receive a free adult membership to the Y.

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    Which Medicare Advantage Plans Have Silversneakers

    While some companies are more notorious for offering fitness benefits, our agents can usually find solutions to any preference.

    Many Advantage plans provide gym benefits to their members, although not every plan or service area offers this benefit.

    Some of the major carriers that provide SilverSneakers are:

    • Aetna

    Our agents can help you to identify coverage and find affordable gym options.

    When Can I Enroll In A Medicare Advantage Or Medicare Supplement Plan

    The Medicare Benefit You Didn

    The Annual Enrollment Period is from October 15 December 7, which is the time of year many Medicare beneficiaries can enroll in new plans or make changes to existing ones.

    Some members qualify for a Special Enrollment Period . Depending on your eligibility, you may have a lifelong SEP, which allows you to make one change per quarter for the first three quarters of the year instead of only during AEP. Some people may only be eligible for a temporary SEP due to a life change, like moving to a new service area.

    If you have just become eligible for Medicare for the first time, you can enroll in Medicare Advantage during your Initial Enrollment Period .

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    What States Is Blue Cross Blue Shield In

    The 36 independent and locally operated Blue Cross Blue Shield companies deliver health insurance coverage to one in three Americans across all 50 states, the District of Columbia and Puerto Rico. In addition, the BCBS Federal Employee Program® insures over five million federal employees, retirees and their families.

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    Is Tricare For Life A Good Deal

    A. Tricare is a great benefit. This Department of Defense-run health plan covers uniformed and retired career service members, National Guard and Reserve members, other qualifying personnel and their families. Heres some good news on costs: Theres no annual enrollment fee or monthly premium for Tricare for Life.

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    What Does A Silversneakers Membership Include

    A SilverSneakers membership comes with access to over 17,000 fitness locations nationwidethats right, with the SilverSneakers program, you can use gyms and all its included amenities in SilverSneakers huge, national network.

    But SilverSneakers is probably even better known for its group exercise classes run by qualified instructors which includes equipment available to use in the classes. The SilverSneakers program also offers social events, a fitness app , online resources for home workouts, and more.

    Additionally, SilverSneakers repeatedly states that it does not sell shoessilver or otherwiseto anyone. It doesn’t give you a free pair of shoes when you become a member either. So you’ll need to BYOS to bring to SilverSneakers classes.

    Does Medicare Pay For Fitness Centers

    Is Silver Sneakers Part of Medicare?

    Original Medicare does not pay for gym memberships or fitness programs, but Medicare Advantage and Medigap plans may offer these benefits. Some Medicare Advantage and Medigap plans offer membership with SilverSneakers or Silver& Fit. These are fitness programs specifically designed with older adults in mind.

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