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Aetna Fitness Reimbursements

URGENT UPDATE APRIL 22, 2024 PLEASE READ ALL INFORMATION BELOW

ALERT: If you are purchasing an item you would not normally purchase without getting a reimbursement, we advise you to NOT MAKE THE PURCHASE.  Please contact us with the specific details so we can check with Aetna first.  We cannot be responsible if you purchase an item that is not qualified for reimbursement.

Please click here to see the PDF of the Fitness Reimbursement form which will need to be submitted with your reimbursement request.
Please check back soon for a copy of your updated evidence of coverage.

Attention Aetna Member,

Urgent message regarding your Aetna fitness reimbursement benefit.  This change applies to any Aetna Medicare plan which has a fitness reimbursement benefit for 2024.

 

We just received this information as of 4-22-24 and immediately went to work to notify you.

 

  • Effective immediately, the fitness benefit can no longer be used for the following items:
    • Athletic shoes (all types)
    • Camping tents
    • Fishing rods
    • Hiking poles
    • National and state park fees
  • An updated fitness direct member reimbursement form, as well as updated Evidence of Coverage and Summary of Benefits documents, will be available on AetnaMedicare.com soon.

 

Per correspondence from Aetna, these changes are effective as of 4-17-24.  Aetna is sending out new information to all members so please watch your mailbox for these important documents.

 

Please review the documents below for more information and clarification from Aetna.

ALERT: If you are purchasing an item you would not normally purchase without getting a reimbursement, we advise you to NOT MAKE THE PURCHASE.  Please contact us with the specific details so we can check with Aetna first.  We cannot be responsible if you purchase an item that is not qualified for reimbursement.

Aetna Value HMO H3146-001 Fitness Reimbursements

Benefit amounts vary by plan. To see the specific amount for your plan, scan the QR code on the back of your card. If you need assistance, please come to our office.
Services that are covered for youWhat you must pay when you get these services in‑network
Fitness program

Fitness program (physical fitness)

You are covered for a basic membership to any SilverSneakers® participating fitness facility.

If you do not reside near a participating facility, or prefer to exercise at home, online classes and at‑home fitness kits are available. You may order one fitness kit per year through SilverSneakers.

You will also have access to online enrichment classes to support your health and wellness, as well as your mental fitness. Health and wellness classes include, but are not limited to: cooking, food & nutrition, and mindfulness. Mental fitness classes include, but are not limited to: new skills, organization, self‑help, and staying connected. These classes can be accessed online by visiting SilverSneakers.com.

To get started, you will need your SilverSneakers ID number. Please visit SilverSneakers.com or call SilverSneakers at 1‑888‑423‑4632 (TTY/TDD: 711) to obtain this ID number. Then, bring this ID number with you when you visit a participating fitness facility. Information about participating facilities can be found by using the SilverSneakers website or by calling SilverSneakers.

Fitness allowance:
You also get a direct member reimbursement (DMR) allowance of $800* each year. You can be reimbursed toward:

    *Benefit amounts vary by plan. To see the specific amount for your plan, scan the QR code on the back of your card. If you need assistance, please come to our office.


  • Fees paid to a qualified physical health/and or fitness club that does not participate with SilverSneakers

  • Aerobic/fitness activity fees paid (including those paid for personal training, lessons, coaching, or exercise equipment).

  • Activity fees such as pickleball fees, golf green fees, ski/lift passes and fees, National and State Park fees, bowling, yoga, stretching, dance classes, and fees associated with extra features at SilverSneakers facilities.

  • Activity supplies such as camping tents, hiking poles, and fishing rods.

  • Weights and fitness supplies such as exercise peddlers, yoga mats, exercise bands.

  • Wearable items such as athletic shoes and tracking devices.


Allowance exclusions:

  • Fees or dues for social clubs, country clubs, gun clubs, and shooting ranges

  • Athletic clothing (except shoes)

  • Edible items such as protein shakes, bars and supplements

  • Bicycle maintenance and repair

  • Services covered by Original Medicare, including but not limited to, physical therapy, chiropractic, acupuncture, or massage therapy services.


This is a direct member fitness reimbursement (DMR) benefit. That means you pay up front for qualified fitness services/activities and submit for reimbursement.

Follow these steps to get reimbursed for the covered fitness services or products you receive:
1. Complete the reimbursement form.
2. Make copies of your documents.
3. Submit the completed fitness reimbursement request and receipt.

How to submit your request:
Visit AetnaMedicare.com/reimburse where you can submit the request and documents online or get direction on how to print and mail the request. Or see the Payment Requests for Medical Coverage ‑ Contact Information section in Chapter 2 of the Evidence of Coverage.

Reimbursement process:
Be sure to complete all of the required fields on the form because incomplete forms will not be processed. It can take up to 45 days to receive payment after all the information is received. Once approved, you will receive a check in the mail for repayment of the covered services up to your benefit amount.

Important: Your receipt and documentation must be submitted before the end of each year to be eligible for reimbursement. If you need assistance with the reimbursement process, you can call the Member Services phone number listed on your Aetna Member ID card.		$0 copay for health club membership/fitness classes.

Additional Information

Received from Jourdan M., Customer Service Representative/Liaison Team

  • Reimbursement for fitness activity fees including fees at fitness clubs and locations NOT included in the SilverSneakers network.
  • Supplies will be covered as long as they are tied to a fitness activity of the member. Different information will be requested depending on the amount of the reimbursement requested:
    • For itemized receipts where requested reimbursement is less than $100, as part of our reimbursement policy, the member must complete and submit the fitness DMR form and an itemized receipt.
    • For itemized receipts where requested reimbursement is greater than $100, the member must submit the fitness DMR form and an itemized receipt. In addition, the member must provide details that demonstrate that the member is personally using the item purchased is for a fitness activity for themselves. Instructions on the type of documentation or evidence required will be described on the fitness DMR form.
      • Every purchase over $100 will require the description of the activity when the member submits the DMR form. For example, member will need to complete the open box section on the fitness DMR form to explain how they are using this their purchase to stay healthy. Encourage Members must send proof of the activity when they can (i.e., green fee, pickleball court, etc …. ) When they are not able to submit proof of an activity, they must fully describe how they are using the item to stay healthy.
  • Supplies must be capable of being used wholly and exclusively for the approved activity rather than dual use. For example, coolers will not be eligible for reimbursement even though they can be used for camping because they also can be used for non-fitness purposes. Athletic shoes are covered but limited to one pair of each type of athletic shoes per member per year for each approved activity. Reimbursement requests for athletic shoes must clearly explain the type of shoe in the itemized receipt or be clearly explained in the open box section on the fitness DMR form
  • Wearable tracking devices (for example Apple Watch, Fit Bit, etc.) are covered and are limited to the sole use of the individual member. Only one wearable tracking device will be covered.

Thank you for choosing to do business with Aetna. We would love to hear your feedback, please take our survey! If you require further assistance, please contact the Broker Services Department via email at [email protected] or by phone at 1-866-714-9301. We are here from 8am to 8pm (EST), Monday thru Friday.

As a reminder, please ensure all emails sent containing PHI are sent secure.

Jourdan M.

Customer Service Representative/Liaison Team

Aetna Individual Medicare Broker Services
2222 Ewing Road, Moon Township, PA 15108