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How Can I Get Silver Sneakers If I Have Original Medicare?

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Mental and physical well-being is an important part of overall health at any age. Silver Sneakers is a well-known program that is catered to seniors. Medicare recipients can save on health care costs by taking advantage of wellness opportunities with Silver Sneakers.

Find out what Silver Sneakers offers, how to get access to it, and how you should make choices on your Medicare options in regard to Silver Sneakers.

What Is Silver Sneakers?

Silver Sneakers is a health and wellness program geared toward people who are 65 or older. Members can access the following:

  • Access to 15,000 gyms and participating fitness centers around the country
  • A community both online and in person
  • Exercise classes geared toward seniors and led by trained instructors
  • Online and a large on-demand video library of workouts

The program offers seniors a mix of activities that can be in and outside of the gym. Non-gym classes can be in locations such as parks, community centers, and churches with options including swimming, hiking, or yoga.

Silver Sneakers also offers a great tool to look up classes and participating locations throughout the United States. You are allowed to use any facility that contracts with Silver Sneakers without additional costs. For many seniors who opt to travel or are snowbirds, the class lookup can be an excellent resource for you to continue to be active even away from home.

Finally, Silver Sneakers offers “member-only” health seminars and other wellness events.

Does Medicare Cover Silver Sneakers?

Silver Sneakers is not a benefit offered under Original Medicare, also known as Part A and B. You can only get access to the program by signing up for private Medicare insurance, such as a Medicare Advantage Plan or a Medicare Supplement plan (Medigap).

Not all Medicare Supplements and Medicare Advantage Plans offer Silver Sneakers and plans can opt in or out of the program as the plan chooses.

Medicare Advantage Plans are more likely to offer Silver Sneakers as a benefit. This includes Dual Enrollment participants (also known as Dual Eligible Special Needs Plan or D-SNP) that have both Medicare and Medicaid.

Which Parts of Medicare Cover Silver Sneakers?

None of the parts of Medicare cover Silver Sneakers. Silver Sneakers is a private company that markets to private insurance companies to offer additional benefits to you. Medicare Part C (Medicare Advantage) or a Medicare Supplement Plans may offer Silver Sneakers as a benefit, but are not required to do so by Medicare and can end participation in the program at the plan’s discretion.

Silver Sneakers offers a tool that allows you to look up which Medicare Supplement and Advantage Plans offer Silver Sneakers as a benefit.

How Much Does Silver Sneakers Cost?

Silver Sneakers does not cost anything more than the premiums, if any, for your monthly plan. The insurance company pays the associated costs directly to Silver Sneakers.

Compare similar insurance policies, where the only difference is if Silver Sneakers is offered as a benefit or not, to make sure you’re not overpaying for coverage only for Silver Sneakers.

Should Silver Sneakers Coverage Impact Your Medicare Coverage Choices?

No. While Silver Sneakers is a great plan, you should not make health insurance choices based on the program itself. You should always choose your Medicare plan and evaluate your Medicare coverage options based on your medical and health needs. Making sure your doctor is in-network or that your prescriptions and pharmacy are in-network is always more important than selecting a plan for the non-Medicare related benefits. There are a few reasons why.

Why You Shouldn’t Choose a Medicare Plan Based on Silver Sneakers
Silver Sneakers is an optional plan for Medicare Supplement and Medicare Advantage Plans.  Despite its appeal, Medicare does not cover Silver Sneakers. Private insurance companies make the determination on if the company continues to carry it or not.

As an example, in October 2019, United Healthcare stopped offering Silver Sneakers as a benefit for Medicare Advantage Plans in 11 states, along with 1.3 million customers with Medigap insurance in nine states. It was a controversial business decision by UnitedHealthcare, but it shows that insurance companies can make changes to Silver Sneakers.
The cost may not be worth it. Medicare supplements and Medicare Advantage Plans can charge additional premiums for policies. The cost of a policy that offers Silver Sneakers vs. a plan that does not can be significant enough that it would be less expensive to pay for a monthly gym membership.
Medicare Advantage Plans can change annually. Unlike Medicare supplements, which are standardized by plan letter, Medicare Advantage Plans can change annually. These changes can include copays, deductibles, and coinsurance for your medical treatment, changes in prescription drug coverage, or provider networks that you use.

If you select a plan with Silver Sneakers and need to make a change to a different plan that offers the program, your membership information will transfer and stay with you. This means you will not have to reregister or get new membership materials to keep your membership in good standing.

If you change to a Medicare Advantage Plan or Medicare Supplement that does not offer Silver Sneakers, you will lose all membership benefits and there is no option to pay on your own.
Travis Price
Travis Price
Medicare consultant

Travis Price is a licensed independent health insurance agent specializing in Medicare private insurance programs, including Medicare Advantage and Part D drug plans. Price has been in the Medicare industry since 2004, first in South Carolina and now in the Traverse City, Michigan, area.

He earned a bachelor’s degree in business management and accounting from Baker College. Price has worked with hundreds of Medicare-eligible beneficiaries to ensure they get the best plan to fit their medical needs without forcing them to pay for coverage that is unnecessary, saving them hundreds of dollars per year in health insurance costs.

Price supports his clients as an advocate, informing Medicare beneficiaries of their options and answering questions. He’s an active Medicare and insurance contributor on LinkedIn, Quora, and YouTube.

Travis Price
Travis Price
Medicare consultant

Travis Price is a licensed independent health insurance agent specializing in Medicare private insurance programs, including Medicare Advantage and Part D drug plans. Price has been in the Medicare industry since 2004, first in South Carolina and now in the Traverse City, Michigan, area.

He earned a bachelor’s degree in business management and accounting from Baker College. Price has worked with hundreds of Medicare-eligible beneficiaries to ensure they get the best plan to fit their medical needs without forcing them to pay for coverage that is unnecessary, saving them hundreds of dollars per year in health insurance costs.

Price supports his clients as an advocate, informing Medicare beneficiaries of their options and answering questions. He’s an active Medicare and insurance contributor on LinkedIn, Quora, and YouTube.

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