Fitness Reimbursement

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Who is eligible for this benefit?

• Subscribers and covered dependents of fully insured commercial plans.

• Eligibility varies for members of self-insured plans.

This benefit is not available to members on the following plans:

• Medicaid

• Medicare

• Individual Marketplace Standard Plan

• Federal Government Employees

Still not sure if you’re eligible? Call CDPHP at the number on your ID card. 

I do have this benefit. What qualifies? 

• Visit the gym or attend an in-person or digital fitness class at least 50 times to qualify for reimbursement of up to $200 for subscriber, or up to $100 collectively for covered dependents.

• Eligible members can submit for reimbursement up to two times per plan year for a total reimbursement up to $400 for subscriber, or $200 collectively for covered dependents.

• Sports activities for dependents under the age of 18 (soccer club fees, youth rugby, gymnastics, etc.) can be used for the covered dependent portion and do not require a specific number of “visits” to qualify.

• Parent and baby classes such as parent and baby yoga, swim lessons, etc. Parent and baby classes should be submitted under the dependent portion.

• Wearable fitness devices such as an Apple Watch or Fitbit. Please note there is a cap on how much of your reimbursement amount can be used for qualified devices. Subscribers can be reimbursed up to $200 for qualified devices (out of the $400 maximum) and covered dependents can be reimbursed up to a combined $100 for qualified devices (out of the $200 maximum).

• Eligible members need to submit for reimbursement within one year of the end of their plan year

How often can I submit for reimbursement?

• Eligible members can submit for reimbursement up to two times per plan year to get reimbursed up to $400 for subscriber, or $200 for spouse/domestic partner

• Eligible members need to submit for reimbursement within one year of the end of their plan year

What qualifies as a gym?

• A gym or exercise center that houses traditional exercise equipment and is open to the general public

• Virtual or online fitness program subscriptions that include digital fitness classes (Peloton, Beachbody, etc.)

• Specialty fitness studios (i.e. yoga, barre, Pilates, indoor cycling, Metabolic Meltdown etc.)

What expenses qualify for reimbursement?

• Annual membership fees paid for qualifying gyms

• Monthly or annual subscription fees paid for virtual or online fitness classes and at home workouts.

• Fees paid for individual classes or a package of classes at specialty fitness studios.

Membership fees for adult sports leagues, country clubs, weight loss clinics, spas, or other similar facilities do not qualify for reimbursement. Fitness equipment fees are not eligible for reimbursement.

What are acceptable proofs of payment?

• Copy of a bill from facility or program showing fee(s) paid or a credit card statement. Member name, facility or program name, amount paid, and date(s) of payment must be included.

Tips for submitting an acceptable claim:

• Make sure the subscriber submits electronically.

• Submit separate electronic claims and documentation for subscriber and covered dependent.

• We're here for you! Call us with questions!

Submitting for reimbursement online is quicker and easier, but there is also a paper form if you’d rather mail it in.