Today’s insurance market can cover lots of health-related costs, but many wonder if premium services like a personal trainer can be covered by health insurance.
In most cases, the costs of hiring a personal trainer cannot be covered by regular health insurance. However, you may be able to get coverage for a limited time if a personal trainer’s services are approved as medically necessary by your doctor.
We’ll look at how you can take the appropriate steps to get your health insurance to pay for your training professional, and what conditions allow you to do so.
Is a Personal Trainer Covered by Health Insurance?
The short answer is, in most cases, no, but it does depend on your insurance carrier.
A personal trainer can be a great benefit to someone on their fitness journey, and is a wildly popular trend in the fitness industry. They can coach you through an exercise plan, offer customized fitness nutrition, and tailor all aspects of your plan to your personal health goals.
However, some of these experts may only be self-taught, and while they may be perfectly capable they sometimes do not require a professional license to practice their work. Self employed personal trainers can also offer exercise and training sessions without being connected to a gym facility.
A government-based insurance policy will not cover any treatments that are not provided by licensed professionals. While many personal trainers do maintain professional certifications, they are not always required to enter the profession.
Furthermore, while none would dispute the health benefits of a fitness regimen, personal training sessions are usually not considered to be an essential purchase, and are not covered by most policies.
Some private insurers may cover some of the costs of things like a trainer or a gym membership. However, these plans typically cost more for the insured party, or may require a higher premium if sponsored by your employer.
Ways to Cover Your Personal Trainer Costs
The easiest way to get your personal training sessions covered by your health insurance is to have the trainer services prescribed by your healthcare provider. They can deem a personal trainer medically necessary, which can give you a limited opening to have the costs of a trainer be reimbursed by your insurance company.
Examples of such circumstances may include an extended period after an injury or accident when the initial physical therapy has been completed and further targeted exercise training is required. Some chronic conditions may also lead to a doctor or specialist approving the use of a personal trainer.
Why Networks Matter
The healthcare marketplace provides plenty of options for those who want to purchase their own health insurance. There is lots of information about each available policy, and it is up to you to thoroughly review the terms and conditions of each one before making a selection.
Insurance networks offered by the government will usually come at a lower monthly premium cost, but won’t offer some of the services that private insurers will. A private health insurance company can be more generous with their benefits or terms, but you will also pay more for the flexibility.
Consider all of your health-related information before making the choice that is right for you and your family to ensure that you are covered for all of the services that matter most to you.
Requirements for Physician Recommendations
Your doctor can provide a letter of medical necessity to submit to your insurance company to allow them to cover the costs of a personal trainer. This type of letter will be bound to a specific instance or period of time, and will specify that such sessions are required for the treatment of a defined medical condition.
The letter will dictate the exact conditions and prescribed treatment plan that the personal trainer will offer. It will likely also be authorized in conjunction with further examinations to assess your progress. And once those prescribed sessions run out, or the allotted time frame expires, you will have to pay the rest of the costs out of your own pocket.
Doctors may also specify which facility - or even the individual trainer - who is authorized to offer personal training. This means that, even if you can get the costs of a personal trainer covered by your insurance, you will not get to choose anyone you want to do it.
One possible way around this would be to think about if your desired personal trainer works at a facility that is co-managed by primary care physicians. This can be a way to cut through the logistics of the insurance billing process.
If your wellness center offers personal training programs that are supervised or authorized by your primary care provider, you may be able to receive a direct referral within the practice to that trainer. However, such instances would be extremely rare.
Personal Fitness Allowances
Some health insurance plans will provide an annual stipend for costs related to physical fitness. It may be a relatively low amount to help offset the costs of a gym membership or personal trainer.
They may also specify a limited quantity of sessions that will be covered by your insurance.
However, the cost of keeping up with a personal trainer are usually much higher than what the stipend will allow.
Reimbursements for Personal Trainer Costs
In most cases, getting the costs of a personal trainer covered by your insurance provider does not mean that the insurance company will pay for those services directly.
Instead, you will pay for the service yourself, then submit your receipts along with the letter to receive a reimbursement for those costs.
Review your insurance policy’s conditions for a flexible spending account (FSA) or health spending account (HSA) to see what you might be able to spend those funds on, and if a trainer could be covered.
Medicare and Personal Trainer Costs
Medicare is a government-sponsored healthcare plan intended for seniors 65 years and older. It typically covered a broader range of services and care plans than other insurers.
Some healthcare services that are covered by Medicare include an annual wellness visit as part of your preventative services. These types of visits can keep you on the path to physical fitness, and uncover any lurking illnesses or concerns you should be aware of.
Despite its broader scope, Medicare will still not pay for personal trainers directly. That being said, it may cover the cost of gym memberships that offers classes hosted by personal trainers or other fitness professionals.
This access to gym facilities may remove some of the upfront costs to accessing personal training services, allowing seniors who use Medicare to spend those funds on a trainer if they so choose.
How to Shop the Insurance Market
As we’ve mentioned, look into the terms of your FSA or HSA accounts to see if your insurance will cover the costs of a personal trainer.
A health reimbursement arrangement may also be an option, depending on your healthcare plan.
Accounts that would not consider those costs eligible would include a limited-purpose flexible spending account or a dependent care flexible spending account. Such accounts are more stringent in their requirements.
