CurrentHawaii Medical Service Association (HMSA)Policy N/A

EngageFitness Complementary Care Rider

Describes supplemental fitness-related benefits (EngageFitness program) available to HMSA members and covered dependents, including fitness center memberships, home fitness kits, digital tools, member fees, and exclusions. Applies to members whose medical plan coverage includes this Rider.

Policy Summary

PayerHawaii Medical Service Association (HMSA)

PolicyEngageFitness Complementary Care Rider

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionMembers age 16 and older may enroll and pay via EngageFitness.com or by calling the program; no prior authorization is required.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

16+Member eligibility age

$100Fitness Center annual fee

$10Home Fitness Kit annual fee

30-200Premium monthly buy-up range

1Home Fitness Kit per year

EngageFitness Coverage Criteria

Covered services, member obligations, and exclusions for the EngageFitness program.

You and your covered dependents age 16 and older are eligible for the EngageFitness program as described below. Talk to your doctor before you start or change your exercise routine.

Covered Services

Fitness Center Membership: Annual membership at a participating EngageFitness fitness center. Members may request to change Standard fitness centers once a month. Enrollment in multiple Premium fitness locations is permitted; monthly buy-up fees may apply depending on the fitness center chosen. Members are responsible for any fees associated with upgrading membership or using non-standard services or amenities that require separate fees.
Home Fitness Kit: Choose one Home Fitness Kit each benefit year from available options (examples include Fitbit or Garmin wearable tracker kits, Pilates, Strength, Swim, Yoga, or Walking/Trekking kits). Members must follow EngageFitness website instructions to receive and redeem a promotional code; kits are mailed directly from a third-party vendor. Once selected, kits cannot be exchanged. Shipping times and available kits may vary.

Policy Summary

PayerHawaii Medical Service Association (HMSA)

PolicyEngageFitness Complementary Care Rider

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionMembers age 16 and older may enroll and pay via EngageFitness.com or by calling the program; no prior authorization is required.

SourceLink

On This Page

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Member Fees

Annual Member Fee: $100 Annual Member Fee for Fitness Center Membership. Enroll and pay directly at EngageFitness.com or by calling the EngageFitness program.
Premium Fitness Choices: Buy-up fees for Premium fitness locations vary by site and range from $30 - $200 per month; charges are billed monthly to the member's credit card. Members can view local options at EngageFitness.com.
Home Fitness Kit Fee: $10 Annual Member Fee for the Home Fitness Kit. Pay directly at EngageFitness.com or via EngageFitness Customer Service when selecting your kit.
Fee Conditions: The Annual Member Fee is non-refundable, is required each benefit year renewal (subject to employer plan eligibility), and is required for participation in the Standard and/or Premium network.

Exclusions - Not Covered

Services or supplies provided by any person, company, or provider other than a participating EngageFitness fitness center.
All education materials other than those produced for the EngageFitness program by American Specialty Health Incorporated.
Telecommunications devices, telephone handset amplifiers, television recorders, and telephones compatible with hearing aids; vision support devices.
Program services or products for individuals other than the EngageFitness member.
All listening devices including, but not limited to, audiotape and CD players.
Services for members with serious medical conditions for which EngageFitness services are not appropriate.
Fitness devices and applications that require a fee are not reimbursed by the EngageFitness program.
Prescription drugs, over-the-counter products, dietary supplements, herbal supplements, vitamins, minerals, weight control or tobacco cessation products, meal-replacement beverages or powders, or any other type of food or food product, whether or not recommended, prescribed or supplied by a health care provider, fitness center, or program.

Coding and Cost-sharing Details

No procedure or billing codes specifiedmixed

No codes listed

Cost-sharing and deductible applicability

Annual Member Fee (Fitness Center)$100 annual member fee; required each benefit year and non‑refundable; required for participation in Standard and/or Premium network.

Annual Member Fee (Home Fitness Kit)$10 annual member fee; required each benefit year and non‑refundable.

Premium Fitness Choices (buy‑up)Monthly buy‑up fees vary by location and option; billed monthly to member's credit card; range $30–$200 per month.

Application to Annual Copayment MaximumAnnual member fees for the Fitness Center or Home Fitness program do not apply toward meeting the Annual Copayment Maximum.

Refund and billing policyThe Annual Member Fee cannot be refunded; premium buy‑up fees are charged monthly to member's credit card.

Enrollment, Eligibility, and Provider Actions

Note

Enrollment and Eligibility

You and your covered dependents age 16 and older are eligible for the EngageFitness program. Enrollment and payment are handled through the EngageFitness website or by contacting the EngageFitness program directly (contact information is on the last page of this Rider). Talk to your doctor before you start or change your exercise routine. Members may request to change Standard fitness centers once a month. Multiple Premium fitness locations may be enrolled with separate monthly fees; monthly fees or additional charges may apply depending on the fitness center chosen. You are responsible for any fees associated with upgrading your fitness center membership or for non-standard services/amenities that require separate fees. Home Fitness Kits are selected once per benefit year; follow the EngageFitness website instructions to receive a promotional code and redeem through the third-party vendor — kits cannot be exchanged and shipping times may vary.

Eligibility: Members and covered dependents age 16 and older.
Enrollment & Payment: Enroll and pay via the EngageFitness website or by contacting the EngageFitness program (contact info on last page of Rider).
Fitness Center Membership: Annual membership at participating EngageFitness centers. Change Standard centers once per month. Premium locations may have separate monthly fees. Participation varies by location and is subject to change.
Home Fitness Kit: Choose one kit per benefit year from available options (wearable trackers or exercise equipment). Redeem promotional code online through the third-party vendor; kit will be mailed. Kits cannot be exchanged; shipping times and available options may vary.
Provider Note: No prior authorization is required for member enrollment in the EngageFitness program.

OpenPayer

EngageFitness Complementary Care Rider

EngageFitness Coverage Criteria

Coding and Cost-sharing Details

Enrollment, Eligibility, and Provider Actions

Definitions