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Medicare and the SilverSneakers Program

exercising with SilverSneakers and Medicare

If you’re on Medicare and know that you may need more exercise, but aren’t sure how to go about it, the SilverSneakers program is a great way for you to get started with fitness or take your fitness goals to the next level.

In this guide to Medicare and SilverSneakers, we’ll review all the basics of the SilverSneakers program, including what it is, what it covers, how much it costs, and how it works with Medicare. We’ll also cover the wonderful benefits of fitness and exercise, especially for those who are aging into Medicare .

What Is SilverSneakers?

SilverSneakers is a complete fitness and wellness program focused on physical health for adults 65 and older. SilverSneakers programs are only available with certain Medicare plans. Classes and activities aim to improve the overall well-being of seniors at all levels and abilities.

Although SilverSneakers is traditionally known for offering access to gyms and health clubs, they have expanded to offer a complete range of fitness and wellness activities and programs.

What is Included in the SilverSneakers Program?

SilverSneakers currently offers:

The FLEX component of SilverSneakers has really brought their wellness offerings into the forefront of fitness for seniors. The FLEX community classes don’t resemble the gym at all. For people who don’t enjoy gyms, or prefer alternatives to lifting weights or riding an exercise bike, FLEX is an intriguing option.

The FLEX program offers a variety of senior workouts and fitness options in friendly, no-stress settings including:

  • Parks
  • Recreation centers
  • Churches

Activities and classes offered in the FLEX programs include:

  • Tai Chi
  • Yoga
  • Boot camps

All classes are led by certified coaches and trainers. With FLEX, you can get out of your house, while staying out of the gym, and engage in any level of exercise you’d like. Plus, you still have access to all of the in-gym and online classes offered by SilverSneakers.

Something that isn’t included, though, is personal coaching or one-on-one training. All of the SilverSneakers classes and programs are geared either towards open-access gyms (you have the run of the gym) or group classes.

Who Is Eligible For SilverSneakers?

The only eligibility requirement for SilverSneakers is that you’re covered by a participating Medicare plan. Although there’s a common assumption that you have to be 65 or older, SilverSneakers eligibility is not based on age. So if you’re in Medicare before age 65, rest assured that you can use SilverSneakers as long as your plan offers it.

How Does SilverSneakers Work?

For you as a user, SilverSneakers membership is very simple. If you qualify for it, you simply enroll online. Once you’re enrolled, you have access to 100% of the program and benefits offered by SilverSneakers.

For starters, you could look for a gym. This has historically been what SilverSneakers is known for. You can use their fitness club locator to find the gyms or facilities that are closest to you.

You get the benefits of a gym membership, without having to pay for it. Instead, SilverSneakers has a payment arrangement with the gyms and facilities in their network. Wonderfully, you don’t have to be involved with those details.

You simply show up at the gym or facility of your choice and start working out.

Here are some things to keep in mind:

  • It might be a good idea to chat with the staff to see how the facilities are laid out.
  • You might also want to ask the staff which classes and other privileges are included in your free membership.
  • One last thing to check is their COVID-19 policies regarding occupancy, masks, and other safety protocols. But you don’t need to complicate this. Simply sign up, get the necessary info, and then show up.

Is the SilverSneakers Program Free?

The SilverSneakers program is included free of charge with many Medicare Advantage plans, along with some Medigap plans. Medicare recipients with these plans don’t have to pay for SilverSneakers services, which include a basic membership to some gyms, live online fitness classes, and more. However, if you want services the program doesn’t cover, such as personal training at the gym, supplements, or other products, you’ll have to pay for those.

Does SilverSneakers Pay for Gym Membership?

SilverSneakers members may be able to get a free basic membership at thousands of participating gyms, fitness locations, and community centers across the country. However, not all gyms are part of the program. That means you’ll need to check with specific gyms in your area to ask if they honor the SilverSneakers membership.

If you are eligible, some benefits of SilverSneakers include the use of gyms who participate in the program. Some plans cover the SilverSneakers program and members will be able to join select gyms.

The good news is that because there are SilverSneakers partners across the country, you can use your SilverSneakers membership at participating gyms when you travel as well.

SilverSneakers Classes Online

There are many other benefits of SilverSneakers besides the ability to use “in-person” facilities. This is especially true as a result of the Coronavirus pandemic. SilverSneakers has responded to the perils of quarantine and lock down by expanding their online offerings. The aim is to help counteract adverse health consequences due to isolation, immobility, and negative emotions.

SilverSneakers makes two kinds of online fitness content available:

  • Live classes via Zoom
  • On-demand classes directly on the SilverSneakers website
  • The live classes are just what they sound like: classes that you can take as they happen. SilverSneakers has a schedule of upcoming classes on their website. There is no additional fee for using the live classes.
  • As for the on-demand classes, these are also viewed on the device of your choice using an internet connection. You can simply search for a class that interests you and play it whenever you want. You don’t have to wait for the class to go “live.”
  • For the on-demand and live programs, you can find a great variety of offerings, including:
  • Yoga
  • Movement
  • Cardio
  • Strength training

Medicare and SilverSneakers

How do Medicare and SilverSneakers work together? This section will help you understand the specifics of how you can get SilverSneakers through Medicare.

Does Medicare Cover SilverSneakers?

Original Medicare, the basic government program, does not cover SilverSneakers. However, if you use a Medicare health or Supplement plan offered by a private insurance plan contracted with the government, private insurance option, you might have access to the program.

SilverSneakers is available to people who use either:

Does Medicare Automatically Include SilverSneakers?

If you have a Medicare plan that includes SilverSneakers, you are automatically enrolled. You can check your eligibility on the SilverSneakers website, or contact your Medicare plan provider. SilverSneakers is available through specific Medicare Advantage plans or Medigap plans.

SilverSneakers And Medicare Advantage

For Medicare Advantage plans, SilverSneakers will come as an “AdditionalExtra Benefit.” AdditionalExtra benefits are those offered by the plan beyond what’s covered by Original Medicare Part A and Part B. Other Medicare Advantage additional extra benefits often include vision and hearing coverage, rides to appointments, and dental coverage.

SilverSneakers is either included with your Medicare Advantage plan, or it’s not. You won’t be able to add SilverSneakers as an option.

If using this benefit is important to you, you’ll want to specifically look for a Medicare Advantage Plan that offers SilverSneakers.

Can I Join SilverSneakers if I Don’t Have a Medicare Advantage Plan?

Usually, a Medicare recipient gets SilverSneakers through a Medicare Advantage plan. However, if you don’t have an Advantage plan, you may still be able to get SilverSneakers through a Medicare Supplement Plan, known as Medigap. Medigap is additional coverage you can purchase alongside Original Medicare that helps you pay for out-of-pocket expenses.

Not all Medigap plans offer SilverSneakers, and if you don’t sign up for a Medigap plan during your initial enrollment period you aren’t guaranteed acceptance. However, getting Medigap does make it possible to have SilverSneakers with Original Medicare.

SilverSneakers And Medicare Supplement

Medicare Supplement plans, which work with Original Medicare, sometimes offer SilverSneakers as an incentive for you to sign up. Once again, this isn’t an a la carte option; your plan either offers SilverSneakers, or it doesn’t. You can find out in advance whether or not a Medicare Supplement Insurance plan offers SilverSneakers.

NOTE: SilverSneakers is an additional benefit. It is not a part of the core, required benefits of these plans. Insurance companies can change or eliminate extra benefits, including SilverSneakers. So make sure to choose your Medicare coverage based on other healthcare needs, too.

Why Should I Take Advantage of SilverSneakers?

SilverSneakers is a great way to maintain a healthy lifestyle through physical activity. Studies show that even small amounts of exercise can lead to better health and longevity. SilverSneakers eliminates one of the obstacles to physical health: the cost of a gym membership or private workout equipment. By making so many types of exercise for seniors available, SilverSneakers allows you to find an activity that appeals to you - making you much more likely to stick with it.

Among the many benefits of physical activity are:

  • Reduced risk of dying from coronary heart disease
  • Reduced risk of developing diabetes, lung disease, and colon cancer
  • Reduced symptoms of anxiety and depression, lifting overall feelings of well-being
  • Can lower blood pressure
  • Improves flexibility, reducing stiffness, and joint swelling
  • As we age, we’re much more likely to be sedentary and inactive. SilverSneakers is an easy and affordable tool to combat these tendencies and stay vital, active, and healthy.

How To Join SilverSneakers

If your Medicare plan offers SilverSneakers, you’ll want to use your Medicare plan’s member ID card to sign up. You’ll do this online at the SilverSneakers website. If you’re not sure if your plan includes this benefit, you can check your eligibility on their site as well.

If your plan doesn’t offer SilverSneakers, you won’t be able to get it. You can consider switching to a plan that does offer SilverSneakers. Keep in mind though that you probably can’t switch plans in the middle of the year.

Instead, you’ll want to take advantage of one of the enrollment periods allowed by Medicare. For Medicare Advantage, you can use two enrollment periods: The Medicare Annual Election Period (AEP), and The Medicare Advantage Open Enrollment Period (MA-OEP)

The Medicare Annual Enrollment Period is from October 15th to December 7th of each year. If you switch to a new plan, your new coverage is effective on January 1st of the following year.

The MA-OEP is from January 1st to March 31st of each year. Any changes to your coverage are effective on the first day of the month after your enrollment change.

NOTE: It’s important to make sure that any plan you switch to will meet your other healthcare needs. At a minimum, you’ll want to make sure that any Medicare Advantage plan covers your doctors and medications. Don’t switch just to get a fitness benefit.

Changing Medicare Supplement plans can be much more complicated. After your Medigap Open Enrollment Period, you usually have to apply for coverage, and you can be turned down, or charged more for pre-existing conditions. This makes choosing your first Medicare Supplement plan an important decision.

Here are some tips when choosing Medicare Supplement Insurance: If you’re shopping for coverage, try to find a Medigap plan that currently has SilverSneakers because you may not be able to switch Medigap plans later.

You can, however, move from Medicare Supplement to Medicare Advantage during the Annual Election Period (AEP). If you do this, look for a new plan that has SilverSneakers coverage.

Remember that there are no age restrictions for SilverSneakers. So if you have a qualifying Medicare Insurance plan, you’re eligible for SilverSneakers.

To find a participating gym or facility in the SilverSneakers network, just use their locator tool.

Additional SilverSneakers FAQs

Still have questions about SilverSneakers? No problem, we can help. Take a look at these commonly-asked questions and answers.

Is SilverSneakers Free?

SilverSneakers is available without any extra charge. In addition, the individual classes and services are free of charge. You pay a monthly premium for Medicare Advantage (some plans have $0 monthly premiums) and Medicare Supplement plans, though. And you must continue to pay your Part B premium when you enroll in either of these plans.

Who Pays For SilverSneakers?

Your Medicare health plan insurance company pays for SilverSneakers access.

Can I Join SilverSneakers Without Insurance?

No. You must have a participating Medicare health insurance plan to get SilverSneakers.

Does Tricare Cover SilverSneakers?

No. You must have a private Medicare plan like Medicare Advantage or Medicare Supplement Insurance[jla1] .

Does Medicaid Cover SilverSneakers?

No, not by itself. If you have Medicaid and a Medicare plan like Medicare Advantage or Medicare Supplement, then you might be able to have access to SilverSneakers.

Final Thoughts On SilverSneakers

SilverSneakers is a versatile service that connects you to a multitude of fitness options. Using SilverSneakers can help reduce your risk for certain diseases and improve your mental well-being. Because of the lifestyle benefits, it’s worth looking for a Medicare plan that comes with SilverSneakers.

Medicare Advantage plans may offer SilverSneakers, a way to work out at home or at participating fitness locations. Click here to check your eligibility, or call our licensed insurance agents at 1-800-620-4519 (TTY 711) to see if you qualify for a Medicare Advantage plan that may include SilverSneakers as a benefit.

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