Ask Dr Nerenberg | Health and Fitness

How do I go about getting my insursance to pay for a gym membership?

I’ve heard of some health insurance companies that will pay for(or reduce the fees of) joining a health club or gym. Has anyone done this? I am with Blue Cross Blue Shield of Lousiana and the fitness center I would be signing up with is owned by the health care network I use with my insurance. Do I need a doctor’s refferal? Can anyone shed some light on the subject for me?

Sorry to bring bad news, but Blue Cross Blue Shield of LA will not pay for health club fees or dues, even with doctor orders. BCBS limits coverage to specific physical, occupational, etc. therapies. To date, there are no group plans with BCBS of LA that include health clubs, though several businesses are looking into it.

This policy does seem shortsighted – more activity and less weight do mean better overall health. But the problem is one of measurement. For example, in a physical therapy regimen, the therapist does calibrations at the beginning and end and may also do some during the course of a longer treatment plan. The therapist can validate the improvements as well as the patient’s attendance.

Many people lose enthusiasm for their health club and quit going or go less often. It’s a form of “breakage” that health clubs count on. If every member showed up frequently, the club would be overwhelmed.

The answer may be for a health club to take the initiative to structure a results-oriented membership with attendance monitoring, frequent measurement, and the permission of the client to have results reported to insurance or a medical manager. Companies might buy into that and have it written into their group plans.

I have seen ads for other insurance providers that offer discounted health club memberships or partial reimbursement. For example, a Blue EPO in Florida offers $100/$300 annual allowance per family toward gym membership, Lasik, teeth whitening, toddler gym and swim programs and drivers education. Unfortunately, your BCBSLA plan does not.

Hope this helps!

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