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Medicare Health & Fitness Programs

Medicare Recipient Exercising

In the vast majority of cases, original Medicare (Parts A and B) does not cover the cost of physical exercise classes or the services of an exercise therapist or trainer. In a small number of cases, Part B may cover a limited amount of occupational and physical therapy, which could include some exercise and fitness training. This only occurs if your physician has specifically prescribed the therapy.

Part B Physical and Occupational Therapy

Medicare Part B does offer a certain amount of physical and occupational therapy, provided on an outpatient basis. A doctor must prescribe and regularly review the therapy (i.e. it is “medically necessary”), and a Medicare-certified therapist must provide it.
Part B pays 80 percent of the Medicare approved amount for therapy provided independently of healthcare given in the home. The annual cap for therapy provided anywhere other than the outpatient department of a hospital is $1,840. There is no limit on therapy provided in a hospital’s outpatient department, but you may face a co-payment in addition to the 20 percent of the cost you must cover.

Medicare Advantage Exercise Plan Coverage

Medicare Advantage plans (also known as Medicare Part C), must offer you at least the same amount of coverage as Original Medicare, and it could also offer extra benefits that may include exercise program coverage. Bear in mind that when you sign up for Part C, you are still part of the Medicare program and must continue to pay your Part B premiums.
As Part C programs are under no obligation to offer exercise program coverage, it is up to you to find the right program; you can do this at the official Medicare Plan Finder page.
As it happens, several well-known private health insurance providers offer exercise benefits as part of their Part C coverage, including Aetna, Priority Health, HealthPartners, and Humana. The most commonly sought after fitness programs are Silver&Fit and SilverSneakers.

Silver&Fit Exercise and Healthy Aging Program

This exercise program is ideal for seniors; it works with your lifestyle to ensure you stay fit and active. You can go to the official Silver&Fit website and find a fitness facility close to you. While the benefits offered vary depending on the Part C plan and provider you choose, here are a few things offered via the Silver&Fit program:

  • Access to cardiovascular and strength training equipment
  • Access to fitness facility amenities including whirlpools, swimming pools, and saunas
  • Fitness facility exercise classes
  • Online health resources such as health and wellness newsletters

If you wish to be fit and healthy but do not want to travel to a facility, or there is no center nearby, you could receive a variety of home exercise kits, including:

  • Yoga
  • Strength
  • Walking
  • Pilates
  • Tai Chi
  • Dance

These kits usually consist of a guide or DVD, making exercising simple and fun. While some providers (Priority Health, for example) offer Silver&Fit with no deductibles or copayments, others add a small charge ($25 per year for the Fitness Facility Program and $10 per year for the Home Fitness Program).

SilverSneakers

This is another extremely popular exercise program for seniors, offered by a host of insurers on Medicare Part C. There are approximately 13,000 participating fitness centers to choose from around the country, so it is likely there is a facility near you. Use the official SilverSneakers website to find out if your health plan offers the program as part of its additional benefits.

Here are a few reasons to consider SilverSneakers:

  • Amenities such as swimming pools, saunas, and exercise equipment
  • Special classes for seniors overseen by qualified instructors
  • Assistance and guidance from a Program Advisor
  • A number of fun social activities

The SilverSneakers FLEX option is also extremely popular amongst seniors. FLEX features over 50 innovative classes including walking groups, indoor and outdoor boot camp, and Latin-style and line dancing.
A SilverSneakers Steps program enables you to exercise from the comfort of your home. Once you register, you will receive a kit that includes a pedometer, resistance bands, and an exercise DVD. Use these tools to tailor your workout around your lifestyle and individual capabilities.

SeniorPHIT

This stands for Personal Health Improvement Training, and it is a special program offered as part of the Aetna Fitness Program. After registering for SeniorPHIT, you will receive two customized wellness plans that teach you how to eat healthily, exercise correctly, and handle life’s challenges.
An online coach is available 24/7 to chat, and you can reference thousands of articles and healthy recipes on the program’s online resource.

Conclusion

In summary, Original Medicare does NOT cover any of the costs associated with exercise programs for seniors. If you are looking to get fit and active, however, a number of Medicare Advantage plans provide free or low cost options. Staying in shape will ensure you get the most out of your golden years, so look for the right Medicare Part C plan and get active!

Sources
https://www.caring.com/medicare_information/medicare-coverage-of-physical-therapy
https://www.caring.com/medicare_information/medicare-coverage-of-occupational-therapy
https://www.silverandfit.com/
https://www.priorityhealth.com/medicare/once-you-enroll/silver-and-fit
https://www.healthpartners.com/hp/insurance/medicare/minnesota-freedom/silver-fit/
https://my.ephit.com/aetna/
https://www.silversneakers.com/tools/participating-health-plans
http://aetnafit.wholehealthmd.com/AetnaFF.aspx

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