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Posted: August 09, 2004

Medicare Pays for Health Clubs for Some Seniors

Getting to the gym just got a little easier for the elderly now that Medicare covers full health club memberships for some seniors through their HMOs. The deal comes with unlimited access to age-appropriate workouts, weight training machines and even professional trainers.

"It's part of my insurance, and I appreciate it," Earl , 83, of Tamarac , Florida , told the Sun-Sentinel newspaper in Ft. Lauderdale . Twice a week, Earl , who works part-time for a home health company, visits a health club in Coral Springs for the fitness program offered through his HMO.

Early this year, the federal government announced it would increase payments to HMOs under the 2003 Medicare Modernization Act, which authorized prescription drug coverage. The condition was that plan providers use the windfall to enhance benefits in hopes of luring more seniors into Medicare HMOs, which are run by private companies that in turn receive reimbursement from the federal government.

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A few Florida plans decided to put their money into fitness, hoping to trim not only their beneficiaries' waistlines, but their company's payouts as well. Congress says what has long been assumed, that a focus on prevention is more cost effective than traditional Medicare coverage.

HMOs serving Florida 's Palm Beach County were paid as much as 25% more than last year, and those in Broward County as much as 15% more.

"There's no question that a fitness benefit certainly can reduce claims," Mitch Lubitz, a spokesman for Humana, one of the state's largest Medicare HMO providers, told the Sun-Sentinel. Humana, with 230,000 members statewide, began offering the programs in 30 Tampa-area gyms in January and is considering adding a fitness benefit in the South Florida market.

Lubitz said a study by HealthPartners Research Foundation, a private group serving the health care industry, suggests exercise programs can save managed care plans $2,200 per member per year. A study of 23,000 General Motors employees, just published by the University of Michigan, found those who were moderately physically active had $285 less in health costs per year than their sedentary colleagues.

The 2000 Medicare House Outcome Survey reported that 51% of people age 65 to 74, and 65% of those over age 75, do not exercise regularly. Yet research continues to show that even the very elderly and infirm can benefit from a good workout geared to their level. Exercise, the researchers believe, could do everything from help prevent falls to increase mental functioning.

HMOs now might be more likely to consider fitness coverage because older plan members are more interested in nutrition, wellness and fitness. And providers are looking at what can give them a leg up in highly competitive large markets such as Florida , where about 530,300 seniors are enrolled. Lubitz said Humana has started holding some of its plan recruitment seminars at health clubs instead of restaurants.

"The idea behind offering fitness is that seniors want it, as they're more active than they were in the past," said Mohit Ghose , the spokesman for America 's Health Insurance Plans, which represents companies covering 200 million Americans.

RESOURCES

For more information on this topic, check out these resources:

Read the Sun-Sentinel's report about these HMOs and their fitness initiatives.

Another option ? yoga for seniors

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