Health Insurance Gym Membership Reimbursement
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If you've recently decided it's time to join a gym, you might be wondering whether health insurance will help you reduce the price.
Select health insurance providers do offer discounts or rebates on certain gym memberships and exercise classes. These are usually available on a high-level Extras policy. However, you'll need your medical practitioner to state that they recommend you participate in such fitness programs to improve your medical condition.
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Does health insurance cover gym membership?
As per the Australian Government’s private health insurance legislation, gym memberships and exercise fees will only be claimable when your doctor or physiotherapist recommends a specific exercise or gym program to maintain or improve your particular health condition — for example, hypertension, diabetes and unhealthy BMI and arthritis.
Take note: Generally, you won't be able to claim for recreational or competitive sports or activities.
Also, as of 1 April 2019, Extras policies will no longer provide rebates for a range of natural therapies, including Pilates and Yoga. However, if your physiotherapist or exercise physiologist recommends Pilates and/or yoga classes, you might be able to claim a rebate.
How to get a health insurance fitness reimbursement
Gym membership benefits are usually available on Top Extras policies and listed under the company’s 'healthy lifestyle discounts', 'wellness benefits', or 'health management benefits'. Other benefits that might also be claimable if your Extras policy offers health management programs include:
- Yoga, Pilates and swimming lessons.
- Weight management programs.
- Quit smoking programs.
- Health and fitness assessments.
- Access to a dietitian or health coach.
- Exercise physiologist consultations.
- Skin screenings.
Which health insurance covers gym membership?
|Health fund & Policy name||Benefits|
All Extras policies
|All myOwn members have access to the AIA Vitality program, which includes:
|HCF gym membership discounts are generally available if you have an Extras policy that includes health management programs. Up to 10% discount on new 3 to 12-month Platinum or Passport gym memberships from Fitness First.|
Top Extras 85
|You might receive a Medibank gym membership discount rate at Fernwood Fitness, Goodlife Health Clubs and YMCA.|
Top Extras 90
|Receive a Bupa gym membership rebate of up to:
|New Active Plus members might be eligible for 15% off AHM health insurance gym membership at all Goodlife Health Clubs.|
|If your Extras cover includes access to nib approved weight management programs. You might be able to claim a rebate from any fitness centre or weight management program that is recognised by nib.|
|HIF members with an Extras policy that includes Healthy Lifestyle benefits may be able to claim rebates on HIF approved gym memberships and exercise physiology.|
|Teachers Health Fund
|Through there Healthy Lifestyle benefit, eligible members can claim a reimbursement for gym memberships and recognised weight management programs; for example, Jenny Craig and Weight Watchers. Be sure to submit the Teachers Health Fund Healthy Lifestyle form to claim your rebate.|
|Defence Health Fund
|If you have access to the funds Health Management Program, you might be eligible to claim for exercise classes conducted at a gym or by a personal trainer.|
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How do you claim for a gym membership?
Your GP or health professional will generally need to complete the company's health management claim form (usually available from their website). Depending on your health fund, this form can be valid for up to two years, after which you’ll have to re-apply. You’ll need to submit this form, together with copies of all relevant invoices/receipts (make sure you keep the originals).
Take note: Annual limits and waiting periods do apply:
- The amount you can claim back is mainly dependent on your level of Extras cover.
- A 2-month waiting period generally applies before you can claim these benefits.
You can usually complete the above claim process online, via the fund's online member centre, or by using the company's app. Alternatively, you might be able to fax or post the relevant documentation to the insurer.
Frequently asked questions and answers
If you have private health insurance with Extras cover, you can contact your fund and enquire what you need to do to get a gym rebate and how much you'll be eligible for. Review your Private Health Insurance Statement (PHIS) to see if your Extras policy provides membership discount or reimbursements.
It is improbable that a medical professional would recommend Mixed Martial Arts as a way of treating or improving your medical condition. Thus, it is doubtful that private health insurance would pay a rebate or provide a discount towards an MMA gym. However, it's always best to enquire from your insurer directly.
Your health fund might cover the costs of sessions with a personal trainer if your doctor or physiotherapist recommends it. However, your health fund could require that the personal trainer have a recognised certification and be approved by them before they'll pay a claim.
Yoga might be covered by your Extras policy if it is recommended by a registered health professional. They'll have to complete a health management form stating that you require the specific yoga exercises to help you improve your health condition.
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