SilverSneakers fitness benefit
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Defines the SilverSneakers fitness membership benefit available to eligible Blue Medicare Advantage Valor PPO members in Iowa and South Dakota, including covered services, vendor requirements, member cost-sharing, and enrollment options.
No material clinical or coverage changes in this revision.
Covered Benefits and Limitations
Covered Benefit and Conditions
Covered benefit elements and conditions for eligible members:
Applies because Original Medicare does not cover fitness services; benefit scope determined by WMAHP.
Eligible members receive a SilverSneakers membership card and may enroll at participating centers; members must show their WMAHP identification card when enrolling.
The SilverSneakers fitness benefit excludes gym or health club memberships that do not participate in the SilverSneakers program. Members must use a plan-authorized vendor to receive the benefit; memberships at non-participating facilities are not covered.
Services that require added costs (for example, court sports or massage therapy) are not included in the SilverSneakers benefit. If a member elects to receive any such non-covered service, the member is fully liable for the entire charge associated with that service.
Provider / Vendor and Member Operational Requirements
Enrollment with plan-authorized vendor
Enrollment with a plan-authorized vendor — No prior authorization is required for membership. Members must enroll with a plan-authorized SilverSneakers vendor or participating fitness center to receive the benefit. The SilverSneakers benefit does not include gym or health club memberships other than those facilities that participate in the program.
- Members not in close proximity to a contracted fitness center may request SilverSneakers Steps (at-home kit) or use the SilverSneakers GO app.
- Members will receive a SilverSneakers membership card and must show their WMAHP identification card when enrolling at a participating fitness center.
Vendor participation required
Vendor participation required — Members must use a plan-authorized vendor or participating SilverSneakers fitness center to access the benefit. Use of non–plan-authorized vendors or non-participating gyms is not covered and may lead to denial of the benefit.
- The SilverSneakers benefit covers membership payments only at participating facilities.
Member liability for elective non-covered services
Member liability for elective non-covered services — Some centers offer services that require added costs (for example, court sports, massage therapy, or other fee-based activities). If a member elects to receive a non-covered or add-on service, the member is fully responsible for the entire charge associated with that service.
- To verify member eligibility, benefits, and applicable cost share, visit the WMAHP secure website or call Provider Inquiry 1-855-716-2556 (TTY:711).
Key Definitions
Background
SilverSneakers is a specialized fitness program for older adults offered through Wellmark Advantage Health Plan. The program provides membership at participating facilities and program-specific services such as classes, trained staff assistance, and online resources. To receive the benefit, members must enroll with and use a plan-authorized vendor; memberships at facilities that do not participate in the SilverSneakers program are excluded. Additionally, certain on-site offerings that carry extra fees (e.g., court sports, massage therapy) are outside the benefit scope and are the financial responsibility of the member if elected.
Policy Dates & Revision History
Policy updated (document lists 'Updated: 01/01/2026').
Policy became effective (Effective: 01/01/2022).
Policy created (Created: 9/13/2021).
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