EngageFitness Program Benefit Rider (Complementary Care Rider)
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Supplemental EngageFitness program benefits for HMSA medical plan members age 16+ (kits for 18+) that run concurrent with the member's medical plan coverage and are subject to the Guide to Benefits provisions.
EngageFitness Coverage Rules
EngageFitness coverage criteria
Covered and not-covered EngageFitness services and limitations.
Services and products not covered (examples)
- Services or supplies provided by any person, company, or provider other than a participating EngageFitness fitness center are not covered.
- Educational materials not produced by American Specialty Health Incorporated for the EngageFitness program are not covered.
- Fitness devices and applications that require a fee are not reimbursed by the EngageFitness program.
- Program services or products for individuals other than the EngageFitness member are not covered.
- Prescription drugs, over-the-counter products, dietary or herbal supplements, vitamins, minerals, meal-replacement products, weight control or tobacco cessation products are not covered.
- Services for members with serious medical conditions for which EngageFitness services are not appropriate are not covered.
Billing, Coding, and Cost Application
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Enrollment and Member Payment Details (Provider Actions)
Enroll via EngageFitness website or program phone number; use participating centers
Members must enroll in EngageFitness through the EngageFitness website or by calling the program phone number; benefits apply only at participating EngageFitness fitness centers. Members may request to change Standard fitness centers once a month and may enroll in multiple Premium locations (monthly fees may apply).
- Find participating fitness centers on the EngageFitness website or contact the program via the phone number on the Rider.
- Standard fitness center changes allowed once per month.
- Participation and available services may vary by location and are subject to change.
Member payment obligations — annual fees and Premium buy-ups charged to member
Members are responsible for paying Annual Member Fees and any Premium monthly buy-up fees. Annual Member Fees must be paid directly online at EngageFitness.com or by calling the program; fees are charged to the member’s credit card for Premium locations and are non-refundable. The Annual Member Fee is required each benefit year for participation in the Standard and/or Premium network.
- Fitness Center Membership: $100 Annual Member Fee, paid online or by phone.
- Premium locations: monthly buy-up fees of $30–$200 charged to the member’s credit card.
- Home Fitness Kit: $10 Annual Member Fee, paid online or by phone.
- Annual Member Fee is non-refundable and required each benefit year (subject to employer plan eligibility).
Key Definitions
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