My friend gets SilverSneakers with her plan and I don't-how are we both paying for Medicare and getting such different stuff?
Answered by 25 licensed agents
SilverSneakers and other fitness programs are benefits usually provided with the Medicare Advantage plans. Even though both of you are on Medicare, there is a difference in the plans you enrolled in.
The fitness programs are not included with Medicare Supplement plans or in Original Medicare Part A & B. To receive that benefit, you would need to sign up for a Medicare Advantage plan with the fitness benefit included.
She would have a Medicare Advantage Plan and I’d say you have a supplement plan. Supplement plans don’t come with Silver Sneakers nor dental vision and hearing. Drug cards are also seperate with supplement plans.
It all depends on what type of plans that you have and what type of plan your friend has, since not all plans offer silver sneakers.
I will be glad to look into it if I know a little more about the plan that you have, and I can even suggest which plans will pay for silver sneakers for you.
A Silver Sneakers gym membership may be included in some Medicare Supplement plans, and it can also be part of some Medicare Advantage plans. But that benefit is not uniformly offered by ALL plans. If this is important to you, be sure to ask if Silver Sneakers or other gym membership is offered as a benefit under the plan you are evaluating.
Most Medicare Advantage plans offer some gym benefits, but not all are affiliated with Silver Sneakers. There are a few Medicare Supplement plans that include a gym benefit. If anyone would like to review plan benefits, I would be happy to help and explain the differences. Contact me, Please do not hesitate to reach out.
Silver Sneakers is a benefit that comes with some Medicare Advantage Plans and some Medicare Supplement plan. If your friend is enrolled in a different plan than you are, that would explain it!
Different plans use differing gym memberships. They all are basically the same, whether you have an Advantage or a Supplement plan. It is usually a free benefit but since I live in AZ, I can not really speak for some other states. For example, there is another mirror-image of Sneakers called "Silver & Fit". There are situations where you go online to see which of S & F's gyms are located closer to home. The distance should not be a dilemma as there usually are many to choose from near your zip code.
The difference is in the plan itself, some plans offer it and some don’t. In some cases plans that offer SilverSneakers may have a slightly higher premium.
Your friend probably has a Medicare Advantage. Those policies are allowed to have the extra benefits like Silver Sneakers, dental and vision . You probably have a medicare supplement. Historically most do not have a Silver Sneakers benefit. There are a few that are now offering that with their policies.
You are likely enrolled in different types of Medicare plans, which offer varying benefits. While Original Medicare (Parts A & B) doesn't include SilverSneakers, many Medicare Advantage (Part C) and some Medicare Supplement (Medigap) plans do. Your friend's plan likely includes SilverSneakers as an added benefit, while your plan might not.
The reason for the difference in benefits like SilverSneakers is that while Original Medicare (Parts A and B) doesn't include fitness programs, Medicare Advantage plans (Part C) often do. Your friend likely has a Medicare Advantage plan that includes SilverSneakers, while you may have Original Medicare or a different plan that doesn't offer this benefit.
Here's a more detailed explanation:
Original Medicare:
This is the basic Medicare coverage, and it doesn't include fitness programs like SilverSneakers.
Medicare Advantage:
These are plans offered by private insurance companies that must cover all of Original Medicare's benefits, but can also include extra benefits like fitness programs, gym memberships, and more.
Medicare Supplement (Medigap):
These plans help pay for some of the costs of Original Medicare, but they don't generally include fitness programs like SilverSneakers.
SilverSneakers:
This is a fitness program offered by many Medicare Advantage plans, giving members access to gyms and other fitness facilities.
To understand why you don't have SilverSneakers while your friend does, consider these factors:
Plan Type:
You likely have Original Medicare or a Medicare Supplement, neither of which include fitness programs.
Plan Specifics:
Even within Medicare Advantage plans, the specific benefits offered can vary. Some plans may include SilverSneakers, while others may not.
If you'd like to access SilverSneakers, you have a few options:
1. Consider a Medicare Advantage plan:
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Check which plans in your area offer SilverSneakers as a benefit and enroll during the Annual Election Period (October 15 - December 7).
2. Contact your insurance provider:
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Ask them about the benefits of your current plan and whether they offer any fitness programs.
3. Evaluate your fitness needs:
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If a gym membership is important to you, you may need to pay for it out-of-pocket or explore other fitness options.
Most plans offer Silver Sneaker or a different system of gym membership.
When you say you pay for Medicare, you're referring to what the government takes for your pay B, which everyone who has Medicare pay for. The other part is to make sure you check with an agent to make your you're getting all the benefits offered in your area, zip code.
You are welcome to contact me and, with your permission, will do a dive on your system.
There are many reasons why your friends' Medicare Advantage Plan does not mirror your plan. Do you have basic Medicare or a Medicare Advantage Plan? Do you have a Medicare Supplemental Plan? There are many questions that need to be reviewed, and we must take the time to review your needs versus what your coverage entails. You need to reach out to a knowledgeable, informed agent.
Most Medicare plans come with a gym membership through Silver Sneakers or through Silver and Fit and the majority of gym memberships are at $0 cost. Not all gyms are included so you will want to check with your plan provider on availability. Often times you can attend multiple gyms. For example, attend one gym for a spin or yoga class and stop by another gym to pump some iron. Double check your plan because a lot of insureds do have the benefit but are simply unaware it exits.
There are several plans available with medicare, Medicare advantage, and Medicare supplement plans. During open enrollment periods is a great time for you to go over those benefits. If you would like to give me a call I would be happy to set up an appointment to review them with you at any time.
What plan does your friend have and what plan do you have? For example Anthem Medicare Supplement Plan G has Silver Sneakers. Aetna Plan G does not. Be careful that you do not switch to a dis-Advantage plan just for free stuff.
Those memberships usually come with Medicare Advantage plans. Maybe you are on original Medicare (Part A and B) only or you might have a Medicare Supplement plan.
Each carrier is in titled to offer different extras in their plans. Your friend is probably on a different plan than you are. You can always call your carrier to see if you may have a fitness benefit.