Original Medicare does not offer any fitness benefits, including gym and YMCA memberships.
In a word: no, Original Medicare (Part A and Part B) does not cover YMCA memberships, gym memberships, or any other fitness program.
Original Medicare does cover other wellness benefits to help keep you healthy, such as counseling for smoking cessation, obesity screening & counseling, nutrition therapy, and alcohol misuse screening & counseling. However, many Medicare Advantage (Part C) plans do cover a variety of fitness programs.
What is the YMCA?
Often referred to simply as "The Y", the YMCA is a nonprofit organization with a focus on strengthening the surrounding community. With facilities in 10,000 communities across the country, they have a simple mission of providing members with health, security, and a sense of belonging.
The YMCA offers services for children, job training, adult education classes, and health and wellness services/equipment for all members.
Initially conceived in London in 1844, the YMCA found a home in the U.S. just seven years later and has been an important institution across the country ever since. While, at the beginning, the organization had a focus on servicemen and industrial workers, The Y soon expanded into providing things such as swimming lessons, youth programs, adult training classes, fitness centers, and community aid.
There are many such organizations across the country, community centers and facilities designed to offer health and wellness benefits to the people that need them. The YMCA is one of the most recognizable, but there are a plethora of places that offer many of the same services. Most places also have senior centers that provide, not just gyms and wellness programs, but classes, community workshops, and volunteer opportunities.
Does Medicare Advantage cover a YMCA membership?
Medicare Advantage plans have to provide the same level of coverage as Original Medicare, but most – over 98% – include additional benefits. Fitness programs and gym memberships are often part of this, but are not always included.
It is important to remember that Medicare Part C plans are sold by private insurers, so coverage options, as well as cost, vary based on provider. Always be sure to thoroughly check what a plan covers and never assume additional services.
Whether a YMCA membership is part of your Medicare Advantage plan depends on the specific plan and provider you choose. There are several possible options for fitness coverage with a Medicare Advantage plan, but the most popular options include:
Blue Cross Blue Shield Fitness Program
Plans purchased through Blue Cross Blue Shield often include fitness benefits such as classes, equipment access, and lessons. Though these plans are typically more limited than other programs, they are still a great resource. Some Blue Cross Blue Shield plans include SilverSneakers, as well.
The most popular fitness plan offered through Medicare Advantage, SilverSneakers gives you access to classes, exercise programs, and facilities designed for seniors. Several gyms participate in this program, but always make sure there is a convenient location near you.
This program functions essentially the same as SilverSneakers, but may have different participating locations or other differences, depending on your plan.
Silver & Fit
Operating similar to SilverSneakers and Renew Active, this program gives access to classes, equipment, and lessons designed specifically for seniors.
Comparing plan offerings and prices is important, but if you are looking for a plan that includes some type of fitness program, the most important part is making sure you have access to a participating facility.
What wellness programs does Original Medicare cover?
Though Original Medicare does not cover gym memberships, it does provide other wellness benefits for beneficiaries.
Alcohol and substance abuse treatment
Original Medicare covers both inpatient and outpatient care for those living with addiction. This includes hospitalization and rehabilitation, as well as medication management, group or individual therapy, and family counseling. Medicare also has what is known as the SBIRT (Screening, Brief Intervention, Referral to Treatment) program, which is designed to help if you show early signs of unhealthy substance abuse.
One of the best things you can do for your health is quit smoking, and Medicare considers it a preventive service, covering two quitting attempts for free. Each attempt includes four group or individual counseling sessions that can be done through telemedicine or face-to-face. If you have a Medicare Part D prescription drug plan, it should include coverage for at least one smoking cessation medication, with Part C plans possibly covering more options, including over-the-counter methods.
Original Medicare does not cover commercial weight loss programs, such as WW (Weight Watchers), but it does cover other services. These include:
Medical Nutrition Therapy
If you have diabetes, kidney disease, or recently had a kidney transplant, Medicare covers nutrition therapy. This can include an initial assessment of your diet and lifestyle, follow-up visits to monitor progress, group or individual therapy, and help managing any mitigating factors that contribute to diabetes.
Behavioral counseling and obesity screenings for people with a body mass index (BMI) over 30 are both covered by Medicare Part B. Counseling must be done by a qualified healthcare provider in a primary care setting.
Weight Loss Surgery
If you meet the requirements and your doctor deems it medically necessary, Original Medicare covers three different types of weight loss surgery. Your doctor will consult with you to find the best (and safest) option for you.
Does Medigap cover gym memberships?
Medicare Supplement Insurance, usually referred to as Medigap, only covers services covered by Original Medicare, so it won’t help pay for gym memberships or fitness programs. You can, however, use your Medigap benefits to help pay your Part B coinsurance.
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