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Does Medicare Cover Exercise Physiology?

Physiotherapist showing workout record on exercise bike
By Daniel Petkevich
Jan 11, 2023

Original Medicare doesn't cover exercise, but some Advantage plans might have this benefit

Overview of Exercise Physiology and its Benefits

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Exercise physiology is the science of understanding how exercise affects the body. It focuses on how different types of exercise can improve physical performance and health. The study of exercise physiology covers a wide range of topics, including muscle growth, cardiovascular endurance, metabolism and nutrition, injury prevention, and overall fitness. Exercise physiologists also help people with chronic conditions manage and improve their health, such as those with diabetes or heart disease.
Exercise physiologists use various methods to develop individualized exercise plans tailored to each patient’s needs. The goal is to help people reach a higher level of physical fitness, improve their overall health, prevent injury, and achieve long-term success and wellness.

What is Covered Under Original Medicare?

Original Medicare does not cover exercise physiology services. However, some Medicare Advantage plans may provide coverage for exercise physiology as an additional benefit. It is important to check with your plan or contact the insurance company directly to determine whether these benefits are included and, if so, what is covered.

What Types of Exercise or Fitness Benefits are Offered with Medicare Advantage Plans?

Some Medicare Advantage plans include benefits related to exercise or physical activity, such as coverage for gym memberships or fitness classes. These benefits can vary depending on the specific plan and the location in which you live. It is important to check with your plan or contact the insurance company directly to determine whether exercise or fitness benefits are included and, if so, what is covered.
Some examples of covered benefits of Medicare Advantage plans,
  • SilverSneakers program, a gym membership program for older adults, is available through certain Medicare Advantage plans.
  • A gym membership benefit may cover a certain number of visits to a gym per month or a specific dollar amount for gym membership fees.
  • Coverage for fitness classes, such as Yoga or Tai Chi, which can benefit older adults with chronic conditions.
  • Health coaching or personal training.
These unique benefits are plan dependent.

How to Determine if Your Plan Covers Exercise Physiology Services

If you are interested in learning more about exercise physiology services, it is important to check with your Medicare Advantage plan or contact the insurance company directly to determine whether these services are covered. Depending on the specific plan and the location in which you live, coverage may vary. Reviewing your plan’s summary of benefits or speaking with a representative can help you understand the specifics of your coverage.

Tips for Finding the Right Medicare Advantage Plan for You

If you are looking for a Medicare Advantage plan that includes exercise physiology services, there are some things to consider. First, find out if the plans available in your area cover these services. Second, review the cost-sharing details and any additional benefits offered by the plan. Finally, take into account your budget and healthcare needs when making your decision.

Medicare Advantage plans are not inherently bad; they are just misunderstood

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The Importance of Staying Active as We Age

Exercise physiology is a valuable tool for helping individuals stay active and maintain their health as they age. It can help people increase their physical activity levels, improve overall fitness, reduce the risk of injury, and maximize physical potential. Regular exercise has numerous benefits for older adults, including improved strength, balance, and cardiovascular health. For these reasons, it is important to discuss exercise options with your doctor or healthcare provider to find the best plan for your individual needs.

Resources to Help Find the Right Medicare Advantage Plan For You

Whether you are looking for an Original Medicare plan or a Medicare Advantage plan that covers exercise physiology services, there are resources available to help. The Centers for Medicare and Medicaid Services (CMS) offers helpful information on how to choose the right plan for you. Additionally, local State Health Insurance Assistance Programs (SHIPs) provide free personalized counseling about Medicare-related issues and can help you evaluate the different plans available in your area.

Takeaway

Exercise physiology can help people of all ages and fitness levels improve their overall health and physical performance. While Original Medicare does not cover these services, some Medicare Advantage plans may include exercise or physical activity benefits, and it’s essential to understand the benefits that are offered with Medicare Advantage plans before making a decision. Fair Square Medicare is here to answer all of your Medicare-related questions.

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