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Does my Medicare Part D plan or Medicare Advantage plan also provide Silver Sneakers coverage?

Category: Living with Your Medicare Part D Plan
Updated: Sep, 06 2022

Your stand-alone Medicare Part D prescription drug plan (PDP) only provides coverage for your prescription medications and probably does not include a fitness benefit.

However, many Medicare Advantage plans do include fitness program coverage.  Please remember that, as you review Medicare Advantage plan options, there are two types of plans: Medicare Advantage plans with a prescription drug benefit (MAPDs) or Medicare Advantage plans without prescription coverage (MAs).

Please note:  If you wish to have both a Medicare Advantage plan and prescription drug coverage, you will need to seek either

(1) a Medicare Advantage HMO or PPO or PFFS plan that includes prescription coverage (MAPD) or
(2) a PFFS Medicare Advantage plan (MA) that does not include prescription coverage, plus join a stand-alone Medicare Part D plan.

Important: You cannot join a Medicare Advantage HMO or PPO plan (MA) and join a stand-alone Medicare Part D plan.

All Medicare Advantage plans (MAs and MAPDs) provide coverage for your Medicare Part A and Medicare Part B benefits -- and sometimes include limited dental and/or vision and/or Health/Fitness club coverage.

Unfortunately, the Medicare Advantage plan Summary of Benefits documents may not include the specific term "Silver Sneakers" and instead just mention "Fitness Coverage" or some other general description in the plan details.

The good news is that you can learn more about the Medicare plans specifically offering Silver Sneaker coverage from the Silver Sneaker site.

Silver Sneakers has an online system to help you find a Medicare plan in your area that covers their fitness benefit, and you can find the Silver Sneakers Health Plan tool here: https://tools.silversneakers.com/Eligibility/HealthPlans

To begin, just choose your state from the list and then you will see a list of Medicare plans in your state that cover the Silver Sneakers program.

You can even click on the Medicare plan names for more plan details and plan contact information.

If you are looking for additional coverage and benefits, you may also want to contact your insurance carrier and ask about Medicare Advantage plans that include a prescription drug benefit (the telephone number is on the back of your Medicare Part D or Medicare Advantage plan Member ID card).

The Bottom Line:  If you are seeking other insurance coverage along with prescription medications (such as fitness coverage or Medicare Part A and Medicare Part B coverage) , you may want to consider a Medicare Advantage plan that includes prescription drug coverage (MAPD).  Just be sure you understand the benefits and disadvantages of a MAPD plan before enrolling.  You can click here for more of the pros and cons of a Medicare Advantage plan:
"Is there really any difference between a Medicare Part D Prescription Drug Plan and a Medicare Advantage Plan?"

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