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Gym and Fitness Club Reimbursement

2016

For MEDICARE MEMBERS on Advantage RX (HMO), Community (HMO SNP), Select (HMO), and Select Rx (HMO) plans.
Getting and staying fit are important not only to your health, but your happiness, too. That's why our HMO plans* include up to a $40 monthly credit to pay dues to a fitness/health club.
BIG NEWS: We've added Advantage Rx (HMO) to the list of plans including the gym/fitness benefit for 2016! The gym/fitness benefit is also included with your Community (HMO SNP), Select (HMO), and Select Rx (HMO) plans.

How it works: We reimburse you for membership dues/fees to access and use fitness facilities and programs for maintaining or increasing physical activity and fitness in an individualized/self-directed manner. Reimbursements are paid monthly or can be submitted for multiple months at a time.

Reimbursement Procedure
You must pay out-of-pocket to a plan-approved facility/program, then send us the Fitness Reimbursement Form along with receipts or other documentation showing what you have paid.

You may be eligible to get money up front to begin a gym membership if you cannot afford your first month’s payment!  Send us a request to pre-fund you payment (along with a statement from your fitness facility of choice showing how much your monthly dues will be) and we will send you 2 months’ worth of the fees to get started. Please see the Fitness Reimbursement Form.

A few reminders:

  • We will only reimburse your actual out-of-pocket costs.
  • We cover up to $40 a month.
  • You must have been a member of the plan during the month you were enrolled in the fitness club/program.
  • Your receipt/documentation must clearly indicate:
     How much you paid out-of-pocket AND
     The month you were a member of the gym/fitness center. 

Send the completed, signed Gym/Fitness Reimbursement Form and receipt/proof of payment to:

FamilyCare Health Plans 
PO Box 5308
Salem, OR 97304

Limitations 
This benefit does not include: 

  • Special program fees such as diet meal plans, personal training, or private lessons. 
  • Fitness/activity aids such as yoga mats, shoes, clothing, pedometers, computer software, smart phone apps, fitness monitors (e.g., Fitbit), fitness diaries, or fitness/diet/cookbooks. 
  • Food, drink, supplements or other consumables.
  • In-home fitness, health, or activity products, such as treadmills, cross-trainers, game consoles, magazine or online subscriptions, or videos.
  • Social or recreational activities such as golf, tennis, dancing, nature appreciation walks, or spa services.
  • Costs not part of basic membership dues such as locker fees, towel service, child care, late payment penalties, guest fees, visiting member fees, or initiation fees*.

* If a portion of an initiation fee applies toward monthly dues, that portion of the fee can be reimbursed. 

Gyms & Fitness Clubs
FamilyCare Health will reimburse membership dues for gyms and fitness clubs that meet the following criteria:

  • The gym/fitness club must exist primarily to provide facilities, equipment and resources to the public for the purpose of maintaining or improving physical activity and fitness in an individualized, self-directed manner. This can include swimming pools so long as they exist primarily for fitness and/or therapeutic exercise and not mainly for social or recreational purposes.
  • The facility must be open to the public and non-discriminatory.
  • The facility cannot mandate that members take fitness classes, personal or group training, or lessons as a requirement for membership.
  • The facility must provide for the general safety of members.
  • The facility cannot be primarily recreational or social in nature, such as golf clubs, tennis clubs, country clubs, spas, dancing, or nature walks.

For More Information
You can reach FamilyCare Health Navigation Services at:

Phone: 866-798-2273 toll-free
TTY/TDD: 711
Email:  NavigationServices@FamilyCareInc.org
Fax: 503-345-5720
Mail: FamilyCare Health Plans
Navigation Services
825 NE Multnomah, Suite 1400
Portland, OR 97232

*The gym/fitness benefit is not available with the Choice Rx (PPO) or Choice (PPO) plans.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits may change on January 1 of each year. FamilyCare Health Plans, Inc., is an HMO and PPO plan with contracts with Medicare and the Oregon Health Plan (Medicaid). Enrollment in FamilyCare Health depends on contract renewal.

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